Predictors of death during tuberculosis treatment, Phrae province, Thailand

Authors

  • ปิยฉัตร ดีสุวรรณ Department of Social Medicine, Phrae hospital Thailand
  • เนตรทราย เหมืองจา Department of Social Medicine, Phrae hospital Thailand

DOI:

https://doi.org/10.14456/dcj.2014.19

Keywords:

mortality density rate, median follow up time, redictors of death, TB type, co-morbidities

Abstract

Tuberculosis remains a major health problem in Thailand because the patients' mortality rate still high although the effective treatment program has developed. This retrospective cohort study was designed aiming to identify predictive factors of death during tuberculosis treatment and to explore the mortality rate of tuberculosis in Phrae province, Thailand. All patients diagnosed as TB and registred at Phrae hospital since October 2009- September 2011 were reviewed. All patients were followed since the time of diagnosis until the end of treatment. Univariable and Multivariable Cox's Regression were performed to identify possible predictors of death during treatment. There were 469 patients, reviewed; and 66 of them died during treat¬ment (14.0796) or mortality density rate 6.86 per 10,000 persons-days. The median follow up time among survival group was 192 days (ranging from 24 to 365 days) while that in mortality group was 49 days (from 1 to 365 days). Predictors of death were duration of symptoms shorter than 30 days (HR = 2.06, p = 0.046), comorbidities: ischemic heart disease (HR = 3.80, p = 0.006), cerebrovascular disease (HR = 3.57, p = 0.017), malignancy (HR = 5.59, p = 0.001), sepsis (HR = 5.24, p = 0.029), gastro¬intestinal side effects from anti-TB drugs (HR = 3.33, p = 0.001), smear negative pulmonary TB (HR = 2.67, p = 0.008) and extra-pulmonary TB (HR 2.31, p = 0.042). The results of this study suggested that the early close monitoring system after initiating TB treatment is imperative. The early case detection, diagnostic guideline for diagnosis of smear negative pulmonary TB and CO-morbidities control should be strengthened.

References

1. World Health Organization. The burden of disease caused by TB. WHO report 2011 [internet]. 2011 [cited 2013 Oct 20];9-27. Available from: http://whqlibdoc.who.int/ pub- lications/2011/9789241564380_eng.pdf

2. Namwat C. Treatment outcome of Tuberculosis. TB situation in Thailand now and future; 5 March 2012; Thailand Science Park Convention Center. Nonthaburi: Bureau of Tuberculosis; 2012.

3. TB clinic. Annual Report 2010-2013: results of the tuberculosis control program in Phrae hospital. Phrae: Phrae provincial hospital; 2013.

4. Amnuaiphon W, Anuwatnonthakate A, Nuyongphak P, Sinthuwatanawibool C, Rujiwongsakorn S, Nakara P, et al. Factors associated with TB death among HIV-uninfected TB patients in Thailand, 2004-2006. Trop Med Int Health 2009;14:1338-46.

5. Faurholt -Jepsen D, Range N, Praygod G, Jeremiah K, Faurholt-Jepsen M, Aabye M G, et al. Diabetes is a stronger predictor of mortality during tuberculosis treatment: a prospective cohort study among tuberculosis patients from Mwanza, Tanzania. Trop Med Int Health 2013;18:82-9.

6. Alavi-Naini R, Moghtaderi A, Metanat M, Mohammadi M, Zabetian M. Factors associated with mortality in Tubeculosis patients. J Res Med Sci [Internet]. 2013 [cited 2013 Nov 5]; 18:52-5. Available from: http://WWW. ncbi.nlm.nih.gov/pmc/articles/PMC3719227/

7. Moolphate S, Aung M N, Nampaisan O, Nedsuwan S, Kantipong P, Suriyon N, et al. Time of highest tuberculosis death risk and associated factors: an observation of 12 years in Northern Thailand. J Intern Med 2011;4:181-90.

8. Ortiz B A, Carcamo C P, Sanchez J F, Rios J. Weight variation overtime and its association with Tuberculosis treatment outcome: A longitudinal analysis. PLoS One [Internet]. 2011 [cited 2013 Nov 6];6:l-5. Available from: http:// www.plosone.org/article/fetchObject.action? uri=info#>3Adoi<#2Fl 0.1 371 %2Fjournal. pone.00184 74&representation=PDF

9. Getahun B, Amerni G, Biadgilign S, Medhin G. Mortality and associated risk factors in a cohort of tuberculosis patients treated under DOTS programme in Addis Ababa, Ethiopia. BMC Infectious Disease [Internet]. 2011 [cited 2013 Nov 1J; 11 : 1 27. Available from: http:// eds.b.ebscohost.com/eds/pdfviewer/ pdfviewer? vid=4&sid=6a8 96 5d6-9050- 48ba-bf07-e5809f55d0bc9640sessionmgr112&hid=110

10. Saukkonen J, Cohn L D, Jasmer M R, Schenker S, Jereb J A, Nolan C M, et al. An official ATS statement: Hepatotoxicity of antituberculous therapy. Am J Respir Crit Care Med [internet]. 2006 [cited 2013 Nov 1];174:935-52. Available from: http://www.atsjoumals.org/doi/ pdf/10.1164/rccm.200510-l 666ST

11. Lin H, Lin J, Kuo W, Wang Y, Hsu L, Chen J, et al. Tuberculosis mortality: patient characteristics and causes. BMC Infectious Diseases 2014;14:5.

12. Straetemans M, Glaziou P, Bierrenbach A L, Sismanidis D, Marieke Werf J V. Assessing tuberculosis case fatality Ratio: A meta-analysis. PLoS One 2011;6:1-10.

13. Akksilp S, Karnkawinpong O, Wattanaamomkiat W, Viriyakitja D, Monkongdee P, Sitti W, et al. Antiretroviral therapy during tuberculosis treatment and marked reduction in death rate of HIV- infected patients, Thailand. Emerging Infectious Diseases [Internet]. 2007 [cited 2014 March l];3:1001-7. Available from: http:// wwwnc.cdc.gov/eid/article/ 13/7/06- 1506_article.htm

14. Amoran OE. Rates and risk factors for mortality among Tuberculosis patients on directly observed therapy in rural Primary Health Care Centres in Ogun State, Nigeria. Niger Med Pract [Internet]. 2013 [cited 2014 March 1 J;63:74-82. Available from: http://www.ajol.info/index.php /nmp /article /view / 93828

15. Waitt C J, Peter N, Banda K, White A S, Kampmann B, Kumwenda J, et al. Early deaths during Tuberculosis treatment are associated with Depressed Innate Responses, Bacterial Infection, and Tuberculosis Progression. JID [Internet]. 2011 [cited 2014 March 3];204:358-62. Available from: http://jid.oxfordjournals.org/ content / 204/3/358. long

16. Kwon S Y, Chi Y S, Oh J I, Kim S K, Kim Y I, Lim C S, et al. Clinical characteristics and treatment outcomes of tuberculosis in the elderly: a case control study. BMC Infectious Diseases 2013;13:121.

17. Kumarjit S, Izora T, Marak R, Asoka S W. Adverse drug reactions in tuberculosis patients due to directly observed treatment strategy therapy: Experience at an outpatient clinic of a teaching hospital in the city of Imphal, Manipur, India. JACP 2013;1:50-3.

Downloads

Published

2014-06-30

How to Cite

1.
ดีสุวรรณ ป, เหมืองจา เ. Predictors of death during tuberculosis treatment, Phrae province, Thailand. Dis Control J [Internet]. 2014 Jun. 30 [cited 2024 Mar. 29];40(2):130-41. Available from: https://he01.tci-thaijo.org/index.php/DCJ/article/view/154084

Issue

Section

Original Article