Factors Associated with Mortality among Patients on TB Treatment in the Southern Region of Zimbabwe, 2013.

Autor: Takarinda KC; AIDS & TB Department, Ministry of Health & Child Care, Harare, Zimbabwe; International Union against Tuberculosis and Lung Disease, Paris, France., Sandy C; AIDS & TB Department, Ministry of Health & Child Care, Harare, Zimbabwe., Masuka N; Ministry of Health and Child Care, Harare, Zimbabwe., Hazangwe P; World Health Organisation Country Office, Harare, Zimbabwe., Choto RC; AIDS & TB Department, Ministry of Health & Child Care, Harare, Zimbabwe., Mutasa-Apollo T; AIDS & TB Department, Ministry of Health & Child Care, Harare, Zimbabwe., Nkomo B; AIDS & TB Department, Ministry of Health & Child Care, Harare, Zimbabwe., Sibanda E; Health Services Department, Bulawayo, Zimbabwe., Mugurungi O; AIDS & TB Department, Ministry of Health & Child Care, Harare, Zimbabwe., Harries AD; International Union against Tuberculosis and Lung Disease, Paris, France; Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK., Siziba N; AIDS & TB Department, Ministry of Health & Child Care, Harare, Zimbabwe.
Jazyk: angličtina
Zdroj: Tuberculosis research and treatment [Tuberc Res Treat] 2017; Vol. 2017, pp. 6232071. Date of Electronic Publication: 2017 Mar 02.
DOI: 10.1155/2017/6232071
Abstrakt: Background . In 2013, the tuberculosis (TB) mortality rate was highest in southern Zimbabwe at 16%. We therefore sought to determine factors associated with mortality among registered TB patients in this region. Methodology . This was a retrospective record review of registered patients receiving anti-TB treatment in 2013. Results . Of 1,971 registered TB patients, 1,653 (84%) were new cases compared with 314 (16%) retreatment cases. There were 1,538 (78%) TB/human immunodeficiency virus (HIV) coinfected patients, of whom 1,399 (91%) were on antiretroviral therapy (ART) with median pre-ART CD4 count of 133 cells/uL (IQR, 46-282). Overall, 428 (22%) TB patients died. Factors associated with increased mortality included being ≥65 years old [adjusted relative risk (ARR) = 2.48 (95% CI 1.35-4.55)], a retreatment TB case [ARR = 1.34 (95% CI, 1.10-1.63)], and being HIV-positive [ARR = 1.87 (95% CI, 1.44-2.42)] whilst ART initiation was protective [ARR = 0.25 (95% CI, 0.22-0.29)]. Cumulative mortality rates were 10%, 14%, and 21% at one, two, and six months, respectively, after starting TB treatment. Conclusion . There was high mortality especially in the first two months of anti-TB treatment, with risk factors being recurrent TB and being HIV-infected, despite a high uptake of ART.
Competing Interests: The authors declare that there is no conflict of interests regarding the publication of this paper.
Databáze: MEDLINE
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