ปัจจัยที่มีผลต่อการเสียชีวิตของผู้ป่วยวัณโรครายใหม่ จังหวัดเพชรบูรณ์ ปีงบประมาณ 2566

Thanyarat Wongchana; Niramon  Pimnumyen; Chanoknun  Fakmit; Sirinapa  Aryuyuen

Authors

Thanyarat Wongchana Professional Nurse, The Office of Disease Prevention and Control 2, Phitsanulok Province
Niramon Pimnumyen Registered Nurse, Senior Professional Level, The Office of Disease Prevention and Control 2, Phitsanulok Province
Chanoknun Fakmit Lecturer, Department of Health Sciences, Faculty of Science and Technology, Rajamangala University of Technology Suvarnabhumi
Sirinapa Aryuyuen Associate Professor, Applied Statistics, Faculty of Science and Technology, Rajamangala University of Technology Thanyaburi

Keywords:

Mortality, Risk factors, New tuberculosis patients

Abstract

This research aimed to study factors affecting mortality among new tuberculosis patients in Phetchabun Province. A retrospective cohort study design was utilized. The study population consisted of 634 new tuberculosis patients registered for treatment in government hospitals within Phetchabun Province during the fiscal year 2023 (October 1, 2022-September 30, 2023). Data were obtained from the national Tuberculosis Database of Thailand using a data recording form developed by the researchers. Factors affecting mortality were analyzed using Cox proportional hazards regression.
The results revealed that among the 634 new tuberculosis patients, 123 patients died (19.4%). Most patients were male (72.2%), with a mean age of 55.36 years (S.D. = 16.37), and 41.8% were aged over 60 years. Factors significantly associated with mortality (p-value < 0.05) included diabetes mellitus (AHR = 5.388, 95% CI: 1.893-15.334), refusal of HIV testing (AHR = 5.633, 95%CI: 1.997-15.889), overweight (BMI 25-29.9 kg/m²) (AHR = 2.163, 95% CI: 1.088-4.302), obesity (BMI 30 kg/m²) (AHR = 3.590, 95% CI: 1.030-12.515), underweight (BMI < 18.5 kg/m²) (AHR = 2.126, 95% CI: 1.416-3.191), chronic kidney disease (AHR = 3.176, 95% CI: 1.497-6.738), and age over 60 years (AHR = 1.820, 95% CI: 1.219-2.718). These findings suggest that healthcare facilities at all levels should strengthen the management of newly diagnosed tuberculosis patients by prioritizing those with comorbidities, individuals whose body mass index does not meet the standard criteria, and older adults, in order to help reduce the risk of mortality during treatment.

References

Chaisri, S. (2024). Factors affecting mortality among new and relapsed tuberculosis patients, Mancha Khiri Hospital, fiscal years 2020-2024. Journal of Environmental Medical and Health Studies, 9(4), 601-610.

Diewsurin, J. (2025). Integration of risk factors and development of a mortality score to predict prognosis after tuberculosis diagnosis. Journal of Clinical Medical Education Center, King Prajadhipok Hospital, 42(1), 56-65.

Division of Tuberculosis, Department of Disease Control, Ministry of Public Health. (2021). National Tuberculosis Control Program Guideline, Thailand 2021. Aksorn Graphic and Design.

Division of Tuberculosis, Department of Disease Control, Ministry of Public Health. (2022). National Tuberculosis Control Program Guideline, Thailand 2021. Aksorn Graphic and Design.

Division of Tuberculosis, Department of Disease Control, Ministry of Public Health. (2024). The tuberculosis situation and performance in Thailand, 2019-2023. Aksorn Graphic and Design.

Imduang, K., Siripon, K., Nakrit, K., Karikan, T., Saengsuwan, L., Trakoolkollakit, W., et al. (2022). Mortality situation of new and relapsed tuberculosis patients in Health Region 11. Journal of Disease Prevention and Control Office 2 Phitsanulok, 9(2), 76-92.

Khonsomsak, R. (2017). Factors associated with mortality among smear-positive pulmonary tuberculosis patients, Somdet Phra Yannasangwon Hospital, Chiang Rai. Chiangrai Medical Journal, 9(1), 19-27.

Kittijantharopas, C. (2019). Factors associated with mortality among new pulmonary tuberculosis patients, Lampang Province. Journal of Community Public Health, 5(3), 74-82.

Laowitthawat, W., & Saengchat, A. (2024). Factors influencing mortality among new and relapsed tuberculosis patients in Khon Kaen Province, fiscal year 2023. Journal of Health Systems Research and Development, 17(1), 72-82.

National Tuberculosis Information Program. (2024). NTIP data center [Database]. Retrieved October 21, 2024, from http://ntip-ddc.moph.go.th/uiform/Login.aspx

Phasuknit, M. (2024). Factors associated with mortality among tuberculosis patients during treatment at Kanthararom Hospital. Sisaket Health Research and Development Journal, 3(1), 274-285.

Prawan, A., Udomdej, W., Niyomthong, P., & Chatraphiban, T. (2022). Development of a scoring system for predicting mortality among new tuberculosis patients. Journal of Phrae Hospital, 30(2), 103-118.

Sumethwatanin, P. (2019). Characteristics of tuberculosis patients who died during treatment at Banglamung Hospital, fiscal years 2016-2018. Journal of Clinical Medical Education Center, King Prajadhipok Hospital, 36(3), 202–209.

Vélez-Gómez, D., Bonet-Arengas, E. Y., Montes-Zuluaga, C., Montes-Zuluaga, F., & Benjumea-Bedoya, D. (2025). Survival and factors associated with mortality among people with tuberculosis in Medellín, Colombia (2018–2023): a retrospective cohort study. BMJ Open, 15(12), e098788. https://doi.org/10.1136/bmjopen-2025-098788

World Health Organization. (2024). Tuberculosis (Fact sheet). Retrieved January 2, 2025, from https://www.who.int/news-room/fact-sheets/detail/tuberculosis

Xie, Y., Han, J., Yu, W., Wu, J., Li, X., & Chen, H. (2020). Survival analysis of risk factors for mortality in a cohort of patients with tuberculosis. Can Respir J, 2020, 1654653. https://doi.org/10.1155/2020/1654653