Abstract: Objective To investigate factors influencing the therapeutic outcome of the first-time retreated smear-positive pulmonary tuberculosis (TB) patients and to improve the cure rate of retreated smear positive TB patients.  Methods A cluster sampling was used to select all of the first-time retreated smear-positive pulmonary TB patients registered in Wuhan TB center from July 2011 to March 2012, which had a total of 232 subjects. Face to face questionnaire survey and 9 months follow-up were conducted. A total of 232 TB patients were interviewed，and 219 questionnaires were eligible, the qualification rate was 94.4%.χ² test and stepwise logistic regression were used to analyze the influencing factors.  Results Among 219 first-time retreated smear-positive pulmonary TB patients, 156 cases were treated successfully, and the treatment success rate was 71.2%. The treatment success rates of patients with diabetes mellitus and without diabetes mellitus were 51.2% (21/41) and 75.8% (135/178) respectively (χ²=9.860, P=0.002). The treatment success rates of drug resistant TB (DR-TB) patients and those without drug resistance were 55.0% (33/60) and 73.7% (87/118) respectively (χ²=6.351, P=0.012). The treatment success rates of multi-drug resistant TB (MDR-TB) patients and non MDR-TB patients were 26.1% (6/23) and 73.5% (114/155) respectively (χ²=20.538, P=0.000). The stepwise logistic regression revealed that MDR-TB (OR=10.758, 95%CI=3.481-33.247) was the risk factor for treatment success, the difference was highly significant (P<0.01). With diabetes mellitus (OR=2.838, 95%CI=1.187-6.788) and treatment without supervision by doctors (OR=1.678, 95%CI=1.087-2.588) were also the risk factors for treatment success, the diffe-rence were significant (P<0.05). Conclusion The treatment success rate of the first-time retreated smear-positive pulmonary TB patients was low in Wuhan. MDR-TB, with diabetes mellitus and treatment without supervision by doctors were the main influential factors on therapeutic effect of first-time retreated smear-positive pulmonary TB.

Key words: Tuberculosis, pulmonary/drug therapy, Recurrence, Treatment outcome, Wuhan city