Factors Associated with Deaths in New and Relapsed Pulmonary Tuberculosis Patients in Nakhon Nayok Province

Abstract

The objectives of this research were to 1) study the factors associated with deaths among new and relapsed pulmonary tuberculosis (TB) patients in Nakhon Nayok Province and 2) causes of deaths among these TB patients. The subjects were 291 new and relapsed TB patients registered during October 2017 – September 2018 in hospitals under Ministry of Public Health in Nakhon Nayok Province. The new and relapsed TB case record form was developed for the study. Descriptive statistics in the study included frequency, percentage, mean, median, standard deviation and rank. A chi-square test was performed to compare between TB cases with and without deaths (significant level at 0.05). Odds ratios (OR) with 95% confidence intervals (95% CI) were presented. A multiple logistic regression analysis was then performed to compute adjusted odds ratios () with 95% confidence intervals. Of 291 TB cases, 71.8% were male, 24.7% were elderly (aged ≥ 65 year old, 66.0% had universal health insurance and 66.0% had lung cavity, 41.9% had smear-positive sputum and 83.5% received standard drugs. Possible factors associated with deaths were being male (OR 1.812; 95% CI 0.662, 4.958), having smear-positive sputum (OR 1.771; 95% CI 0.768, 4.086), having co-morbid diseases (OR 1.462; 95% CI 0.586, 3.644) and having HIV (OR 2.122; 95% CI 0.668, 6.738). The multiple logistic regression analysis showed possible factors associated with deaths including having HIV ( 2.469; 95% CI 0.734, 8.302), having smear-positive sputum ( 1.890; 95% CI 0.800, 4.463) and having co-morbid diseases (( 1.656; 95% CI 0.611, 4.489). A small sample size in the study might affect the possibility of statistical significance. About 70.4% of deaths were due to TB and 81.5% of them occurred in the first month of treatment. The median duration between clinical features and treatment was about 14 days with a rank of 1 - 370 days Results from this study suggest that disease prevention and control workers should focus on providing knowledge and increasing awareness among the elderly and HIV infected person for early diagnosis and treatment of TB, which will help reduce the mortality rate of TB patients.