TABLE 2.
FACTORS ASSOCIATED WITH RECURRENT TUBERCULOSIS AT LEAST 12 MONTHS AFTER TREATMENT COMPLETION, STRATIFIED BY PATIENT BIRTH ORIGIN – UNITED STATES, 1993–2006
| US-born patients | Foreign-born patients | ||||||
|---|---|---|---|---|---|---|---|
|
| |||||||
| Characteristic of initial TB episode | Adjusted Hazard Ratio | 99% Confidence Interval | P value* | Adjusted Hazard Ratio | 99% Confidence Interval | P value* | |
| Age | 0–14 | 0.30 | 0.09–1.00 | <.0001 | 0.53 | 0.07–3.81 | 0.005 |
| 15–24 | Ref | -- | Ref | -- | |||
| 25–44 | 1.77 | 1.02–3.09 | 1.81 | 0.96–3.41 | |||
| 45–64 | 1.24 | 0.70–2.18 | 1.95 | 1.00–3.79 | |||
| ≥65 | 0.99 | 0.54–1.82 | 1.10 | 0.49–2.49 | |||
| Sex | Female | Ref | -- | 0.13 | |||
| Male | 1.21 | 0.95–1.54 | |||||
| Race/ethnicity† | Non-Hispanic White | Ref | -- | 0.001 | |||
| Non-Hispanic Black | 1.14 | 0.90–1.44 | |||||
| Hispanic | 0.67 | 0.43–1.05 | |||||
| Asian | 0.65 | 0.10–4.08 | |||||
| American Indian | 1.43 | 0.81–2.54 | |||||
| Substance use‡ | No | Ref | -- | <.0001 | Ref | -- | 0.20 |
| Yes | 1.57 | 1.23–2.02 | 1.50 | 0.86–2.63 | |||
| Unknown | 1.28 | 0.90–1.83 | 1.02 | 0.56–1.83 | |||
| Homeless in past 12 months | No | Ref | -- | 0.42 | |||
| Yes | 1.17 | 0.86–1.59 | |||||
| Unknown | 1.01 | 0.62–1.63 | |||||
| HIV | Not positive§ | Ref | -- | 0.17 | Ref | -- | 0.001 |
| Positive | 1.18 | 0.87–1.62 | 2.24 | 1.27–3.98 | |||
| Anatomic site of disease | Extrapulmonary | Ref | -- | 0.87 | |||
| Pulmonary | 1.17 | 0.70–1.94 | |||||
| Both | 1.14 | 0.60–2.16 | |||||
| Acid-fast bacilli smear result (any site) | Negative | Ref | -- | 0.04 | Ref | -- | 0.01 |
| Positive | 1.26 | 0.99–1.61 | 1.56 | 1.06–2.30 | |||
| Unknown | 1.32 | 0.69–2.54 | 0.81 | 0.19–3.50 | |||
| Culture result (any site) | Negative | Ref | -- | 0.07 | Ref | -- | 0.41 |
| Positive | 1.57 | 0.92–2.69 | 1.23 | 0.70–2.15 | |||
| Unknown | 1.04 | 0.37–2.92 | 0.68 | 0.12–3.85 | |||
| Cavity visible on chest radiograph | No | Ref | -- | 0.05 | |||
| Yes | 1.25 | 0.99–1.58 | |||||
| Unknown | 1.19 | 0.74–1.90 | |||||
| Documented sputum culture conversion | Yes | Ref | -- | 0.01 | |||
| No | 0.80 | 0.55–1.16 | |||||
| Unknown | 0.65 | 0.43–0.97 | |||||
| Initial drug regimen | Standard 4-drug | Ref | -- | 0.11 | |||
| INH and RIF only | 1.56 | 0.92–2.64 | |||||
| Other | 1.00 | 0.78–1.29 | |||||
| TB drugs administration method | Directly observed | Ref | -- | 0.10 | |||
| Self-administered | 0.77 | 0.57–1.05 | |||||
| Both | 0.85 | 0.65–1.10 | |||||
| Unknown | 0.97 | 0.30–3.13 | |||||
| TB provider type | Private/other | Ref | -- | 0.02 | |||
| Health department | 1.42 | 1.03–1.97 | |||||
| Both | 1.24 | 0.88–1.75 | |||||
| Unknown | 0.82 | 0.18–3.77 | |||||
| Year of initial TB episode¶ | 1993–1996 | Ref | -- | <.0001 | Ref | -- | <.0001 |
| 1997–2002 | 0.88 | 0.70–1.11 | 0.62 | 0.42–0.91 | |||
| 2003–2006 | 0.25 | 0.14–0.43 | 0.19 | 0.09–0.40 | |||
TB = tuberculosis; HIV = human immunodeficiency virus; INH = isoniazid; RIF = rifampin
Native Hawaiian, multi-racial/ethnicity, and unknown categories not shown as no comparison between patients with later recurrent TB and presumed single-episode cases could be made.
Includes non-injection drug use, injection drug use, and excess alcohol use in past 12 months.
Includes those that tested HIV negative, refused, not offered, HIV test done but result unknown, result indeterminate, and result unknown.
This term was added to adjust for possible secular trends that might not have been accounted for in the model, such as the evolving epidemiology of HIV during the study period.