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Home / The International Journal of Tuberculosis and Lung Disease, Volume 21, Number 5

Recurrence of tuberculosis in a low-incidence setting without directly observed treatment: Victoria, Australia, 2002–2014

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SETTING: Victoria, Australia, is an industrialised setting with low tuberculosis (TB) incidence and universal health care. Individually tailored adherence support for self-administered daily anti-tuberculosis treatment is provided. Directly observed treatment (DOT) is very rarely used.

OBJECTIVE: To review the rate of recurrent TB in Victoria between 2002 and 2014.

DESIGN: This was a retrospective cohort study. All recurrent episodes of TB were reviewed and 24-locus MIRU-VNTR (mycobacterial interspersed repetitive units-variable number of tandem repeats) molecular typing was used where possible to determine the likelihood of relapse or reinfection.

RESULTS: Of 4766 notifications, 32 (0.7%) were recurrent episodes. Of 20 episodes that occurred in patients who had previously completed treatment, 11 were culture-positive (0.4% of 3012 culture-positive episodes): 9 were likely relapses (distinguishable at no more than one of 24 loci) and two were likely reinfections, giving a TB relapse rate among culture-positive episodes of 52.5/100 000 person-years (mean time to study end per patient of 5.7 years). The median time until relapse was 18 months (interquartile range 12–30).

CONCLUSIONS: The low rate of relapse in our setting demonstrates that individually tailored adherence support for self-administered anti-tuberculosis treatment can achieve excellent treatment outcomes.

Keywords: molecular epidemiology; relapse; self-administration

Document Type: Research Article

Affiliations: 1: Victorian Tuberculosis Program, Parkville 2: Mycobacterium Reference Laboratory, Victorian Infectious Diseases Reference Laboratory, Melbourne 3: Department of Health and Human Services, Melbourne 4: Victorian Tuberculosis Program, Parkville, School of Public Health and Preventive Medicine, Monash University, Clayton 5: Victorian Tuberculosis Program, Parkville, Department of Microbiology and Immunology, The University of Melbourne, Melbourne, Victoria, Australia

Publication date: 01 May 2017

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

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