Written Question · S4W-01669 · Session 4
How many people have completed treatment for (a) drug-susceptible and (b) drug-resistant tuberculosis in each of the last five years and ho…
The question
To ask the Scottish Executive how many people have completed treatment for (a) drug-susceptible and (b) drug-resistant tuberculosis in each of the last five years and how many were unable to complete such treatment due to unavailability of drugs.
The answer
Information on the outcome of TB treatment becomes available one year after initial tuberculosis notification. For this reason, the latest data on treatment outcomes are for cases notified in 2008. Outcomes for cases notified in 2009 will be reported in the 2011 Health Protection Scotland (HPS) annual report.
In 2008, 445 cases of tuberculosis were reported through the HPS Enhanced Surveillance of Mycobacterial Infections (ESMI) system. Outcomes data was available for 387 (86.9%) cases, of whom 294 (76.0%) had successfully completed treatment at 12 months. For cases where data on both treatment outcome and drug resistance are available, 80.7% (184/228) of cases with no drug resistance completed treatment, and 70% (14/20) of those with drug resistance completed treatment.
The most common reason for not completing treatment was death (24 cases; 6.2%), still being on treatment (23 cases; 5.9%) and being lost to follow up (21 cases; 5.4%). The majority of cases reported to still have been on treatment at 12 months were on their initially planned course of treatment (16 cases) or had their treatment changed due to intolerance or poor response (three cases). No data is currently collected as to how many patients were unable to complete treatment due to unavailability of drugs.
While ESMI collects data on both TB treatment outcome and whether strains are drug-susceptible or drug resistant, cross-tabulation of this data was only performed for the first time in the most recent Health Protection Scotland annual report. Analysis of data for previous years is therefore not currently available.
ESMI data requires careful explanation as, for example, multi-drug resistant TB takes longer to treat, so all such cases will be recorded as “still on therapy” for treatment outcome at 12 months. Furthermore, individuals with drug resistant TB may have been non-compliant to previous treatment, for reasons other than lack of drug supply, resulting in drug resistant TB.
In 2008, 445 cases of tuberculosis were reported through the HPS Enhanced Surveillance of Mycobacterial Infections (ESMI) system. Outcomes data was available for 387 (86.9%) cases, of whom 294 (76.0%) had successfully completed treatment at 12 months. For cases where data on both treatment outcome and drug resistance are available, 80.7% (184/228) of cases with no drug resistance completed treatment, and 70% (14/20) of those with drug resistance completed treatment.
The most common reason for not completing treatment was death (24 cases; 6.2%), still being on treatment (23 cases; 5.9%) and being lost to follow up (21 cases; 5.4%). The majority of cases reported to still have been on treatment at 12 months were on their initially planned course of treatment (16 cases) or had their treatment changed due to intolerance or poor response (three cases). No data is currently collected as to how many patients were unable to complete treatment due to unavailability of drugs.
While ESMI collects data on both TB treatment outcome and whether strains are drug-susceptible or drug resistant, cross-tabulation of this data was only performed for the first time in the most recent Health Protection Scotland annual report. Analysis of data for previous years is therefore not currently available.
ESMI data requires careful explanation as, for example, multi-drug resistant TB takes longer to treat, so all such cases will be recorded as “still on therapy” for treatment outcome at 12 months. Furthermore, individuals with drug resistant TB may have been non-compliant to previous treatment, for reasons other than lack of drug supply, resulting in drug resistant TB.
In the Official Report
No contribution in the Official Report cites S4W-01669 by reference.