Evaluations of Factors Affecting of Short-and Long-Time of Occurrence of Disease Relapse in Patients with Tuberculosis Using Parametric Mixture Cure Model: A Cohort Study

Kazempour-Dizaji, Mehdi; Varahram, Mohammad; Tabarsi, Payam; Roozbahani, Rahim; Zare, Ali; Emamhadi, Mohammad Ali; Marjani, Majid; Abedini, Atefe; Moniri, Afshin; Madani, Mohammadreza; Baghaei Shiva, Parvaneh

Evaluations of Factors Affecting of Short-and Long-Time of Occurrence of Disease Relapse in Patients with Tuberculosis Using Parametric Mixture Cure Model: A Cohort Study

Document Type : Original Article

Authors

Mehdi Kazempour-Dizaji ¹^{, 2}

Mohammad Varahram ¹

Payam Tabarsi ³

Rahim Roozbahani ³

Ali Zare ²

Mohammad Ali Emamhadi ⁴

Majid Marjani ³

Atefe Abedini ⁵

Afshin Moniri ³

Mohammadreza Madani ⁶

Parvaneh Baghaei Shiva ³

¹ Mycobacteriology Research Center (MRC), National Research Institute of Tuberculosis and Lung Disease (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

² Department of Biostatistics, NRITLD , Shahid Beheshti University of Medical Sciences, Tehran, Iran

³ Clinical Tuberculosis and Epidemiology Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran

⁴ Department Forensic Medicine, School of Medicine Shahid Beheshti University of Medical Sciences, Tehran, Iran

⁵ Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

⁶ Chronic Respiratory Diseases Research Center, NRITLD, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background: The success of treatment strategies to control the disease relapse requires determining factors affecting the incident short-time and long-time of disease relapse. Therefore, this study was aimed to identify the factors affecting of short-and long-time of occurrence of disease relapse in patients with tuberculosis (TB) using a parametric mixture cure model.
Materials and Methods: In this historical cohort study; the data was collected from 4564 patients with TB who referred to the Tuberculosis and Lung Diseases Research Center of Dr. Masih Daneshvari Hospital from 2005 to 2015. In order to evaluate the factors affecting of short-and long-time of occurrence of disease relapse, a parametric mixture cure model was used.
Results: In this study, the estimation of the annual incidence of TB relapse showed that the probability of recurrence in the first year is 1% and in the third and tenth years after treatment is 3% and 5%, respectively. In addition, the results of this study showed that the variables of residence, exposure to cigarette smoke, adverse effects of drug use, incarceration, and pulmonary and extra- pulmonary tuberculosis were the factors affecting the short-time recurrence of TB. The variables of drug use, pulmonary and extra- pulmonary tuberculosis, and also incarceration affected the long-term recurrence of this disease.
Conclusion: Cure models by separating factors affecting the short-time occurrence from the long-time occurrence of disease relapse can provide more accurate information to researchers to control and reduce TB relapse.

Keywords

Tuberculosis

Relapse

Risk factors

Parametric mixture cure model