Trends and risk factors for death and excess all-cause mortality among notified tuberculosis patients in the UK: an analysis of surveillance data.

Autor:	Pedrazzoli D; Dept of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.; These authors contributed equally to this work., Kranzer K; Dept of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK.; These authors contributed equally to this work., Thomas HL; TB Unit, Tuberculosis, Acute Respiratory, Gastrointestinal, Emerging/Zoonotic Infections and Travel Migrant Health Division (TARGETS), National Infection Service, Public Health England, London, UK., Lalor MK; TB Unit, Tuberculosis, Acute Respiratory, Gastrointestinal, Emerging/Zoonotic Infections and Travel Migrant Health Division (TARGETS), National Infection Service, Public Health England, London, UK.; Institute for Global Health, University College London, London, UK.
Jazyk:	angličtina
Zdroj:	ERJ open research [ERJ Open Res] 2019 Dec 16; Vol. 5 (4). Date of Electronic Publication: 2019 Dec 16 (Print Publication: 2019).
DOI:	10.1183/23120541.00125-2019
Abstrakt:	Introduction: In the UK, several hundred patients notified with tuberculosis (TB) die every year. The aim of this article is to describe trends in deaths among notified TB patients, explore risk factors associated with death and compare all-cause mortality in TB patients with age-specific mortality rates in the general UK population. Methods: We used 2001-2014 data from UK national TB surveillance to explore trends and risk factors for death, and population mortality data to compare age-specific death rates among notified TB patients with annual death rates in the UK general population. Results: The proportion of TB patients in the UK who died each year declined steadily from 7.1% in 2002 to 5.5% in 2014. One in five patients (21.3%) was diagnosed with TB post-mortem. Where information was available, almost half of the deaths occurred within 2 months of starting treatment. Risk factors for death included demographic, disease-specific and social risk factors. Age had by far the largest effect, with patients aged ≥80 years having a 70 times increased risk of death compared with those aged <15 years. In contrast, excess mortality determined by incidence ratios comparing all-cause mortality among TB patients with that of the general population was highest among children and the working-age population (15-64 years old). Conclusions: Efforts to control TB and improve diagnosis and treatment outcomes in the UK need to be sustained. Control efforts need to focus on socially deprived and vulnerable groups. There is a need for further in-depth analysis of deaths of TB patients in the UK to identify potentially preventable factors. Competing Interests: Conflict of interest: D. Pedrazzoli has nothing to disclose. Conflict of interest: K. Kranzer has nothing to disclose. Conflict of interest: H.L. Thomas has nothing to disclose. Conflict of interest: M.K. Lalor has nothing to disclose. (Copyright ©ERS 2019.)
Databáze:	MEDLINE
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