Multivariate regression analysis affecting successful treatment of pulmonary tuberculosis patients in western China: a retrospective study in a high-incidence area

Abstract

Abstract Background Guizhou, situated in western China, exhibits a high incidence of pulmonary tuberculosis (PTB) alongside comparatively challenging medical and economic conditions. Our objective was to investigate the determinants influencing successful PTB treatment and their scope, aiming to provide a scientific foundation for targeted interventions and enhancing treatment efficacy. Methods Data encompassing all PTB cases registered in Guizhou's China Disease Prevention and Control Information System from 2017 to 2022 were analyzed. Using the successful treatment rate as the dependent variable, initial univariate analysis of independent variables was conducted, followed by multilevel binary logistic regression analysis to assess variables demonstrating statistically significant disparities. Results A total of 139,414 patients, with an average age of 44 years, were included in the study, comprising 89,802 males (64.41%) and 49,612 females (35.59%). Among them, 66,316 (47.57%) were etiologically positive, and 22,795 (16.35%) had comorbidities. The successful treatment rate stood at 95.77%, with a cure rate of 42.54%. 9 factors were identified to influence the successful treatment rate. These included a higher proportion of females compared to males (OR = 1.178, 95%CI = 1.111–1.249), a higher ratio of students versus farmers (OR = 1.960, 95%CI = 1.649–2.330), and a greater proportion of etiologically negative cases compared to etiologically positive (OR = 1.831, 95%CI = 1.725–1.942). Additionally, initial treatment showed higher success rates than retreatment (OR = 3.046, 95%CI = 2.836–3.272), and PTB patients without comorbidities fared better than those with comorbidities (OR = 1.303, 95% CI = 1.217–1.394). The use of fixed-dose combination (FDC) therapy yielded higher success rates than non-FDC treatment (OR = 1.296, 95%CI = 1.206–1.393). Furthermore, successful treatment rates were lower among the Miao ethnic group (OR = 0.874, 95%CI = 0.809–0.945) and higher among the Buyi (OR = 1.270, 95%CI = 1.137–1.419) compared to the Han. Age also played a significant role, with lower success rates observed in the 41–60 age group (OR = 0.731, 95%CI = 0.638–0.838) and the lowest rates among those aged 61 years and older (OR = 0.604, 95%CI = 0.527–0.693). Conclusions Western China faces ongoing challenges in enhancing its PTB treatment capacity and should prioritize the promotion of FDC therapy. Risk factors that influence treatment outcomes for PTB include male gender, advanced age, belonging to the Miao ethnic group, occupation as a farmer, etiological positivity, retreatment status, and comorbidities such as diabetes and HIV/AIDS. Further investigation is warranted to explore the disparities in successful treatment rates among different ethnicities.