ObjectivesThe goal of this paper is to investigate mortality related to tuberculosis in the state of São Paulo, southeastern Brazil, according to multiple causes of death and their interrelation with other underlying causes.
MethodsThe study investigated deaths related to tuberculosis that occurred in the state of São Paulo in 1998.
ResultsTB was the underlying cause of 1,644 deaths, a 4.6/100,000 population mortality rate. Main associated causes were respiratory failure (46,9%), pneumonias (16.5%), other specified symptoms and signs involving circulatory and respiratory systems (13.9%), cachexia (12.9%), diseases of the circulatory system (10.3%), conditions due to alcohol use (8.4%), septicemias (7.2%) and malnutrition (7.1%). Tuberculosis occurred as an associated cause in another 1,388 deaths. The mortality rate including TB as a both underlying and associated cause was 8.9/100,000 population, practically twice the classical rate. Deaths whose associated cause was reported as being TB had as underlying causes: AIDS (65.3%), diseases of the circulatory system (8.9%), neoplasms (7.5%), and diseases of the digestive system (4.8%). Clinical forms of nervous system and miliary TB were more frequent as a cause associated with AIDS than with other underlying causes (p<0,001).
ConclusionsTotal reports of TB-related death practically doubled its mortality rate as an underlying cause. The increase in TB mortality was demonstrated to be influenced by the AIDS epidemic.
KeywordsTuberculosis. Mortality. Cause of death. Acquired immunodeficiency syndrome. Aids-related opportunistic infections. Underlying cause of death. Mortality rate. Multiple-cause-of-death.