Characteristics and risk factors associated with death during tuberculosis treatment among new patients with pulmonary tuberculosis in the Upper North of Thailand, year 2005-2014
Tuberculosis (TB) remains the public health problem of Thailand. More than 5,000 cases/year were reported success rate was 70.0-75.0% due to death during treatment. This study aimed to analyze the risk factors associated death among new pulmonary tuberculosis patients. It is retrospective study, new pulmonary TB cases who registered at TB clinic of public health hospitals in 8 provinces in the Upper North Thailand. Treatment outcome were reported by TB-Clinic with case management (TBCM) which is the electronic for TB recording in the hospital of Thailand from 2005 to 2014. Statistic analysis was relatives risk by univariate analysis, p<0.05. Of the 39,533 cases, male 71.3%, age >50 years 68.6%, HIV positive 13.6%, comorbidity diseases 10.5%. 33,521 cases survived (84.8%) and death 6,012 cases (15.2%). The risk factors of death were age >50 years (19.3%) (RR1.9, 95% CI 1.8-2.0), HIV positive (27.1%) (RR 2.4, 95% CI 2.3-2.6), patients with comorbidity diseases such hypertension, diabetes mellitus, COPD, renal disease, liver disease and cancer (21.3%) (RR 1.5, 95% CI 1.4-1.6). Among comorbidity diseases, diseases risk were hypertension (19.7%) (RR 1.3, 95% CI 1.2-1.5), COPD (32.2%) (RR 2.2, 95% CI 2.0-2.4), renal disease (41.8%) (RR 2.8, 95% CI 2.4-3.2), liver diseases (38.5%) (RR 2.5, 95% CI 2.0-3.2) and cancer (RR 3.5, 95% CI 2.8-4.5) (p<0.05). Conclusion the HIV positive patient was the strongest risk of death during treatment (33.3%) and aging patient ranks the second (68.6%). More concern on patients with comorbidity diseases have to be taken in to consideration to lower the risk of TB death.
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