Factors associated with death among HIV‐uninfected TB patients in Thailand, 2004–2006

Amnuaiphon, Waraya; Anuwatnonthakate, Amornrat; Nuyongphak, Prungsri; Sinthuwatanawibool, Chalinthorn; Rujiwongsakorn, Sadudee; Nakara, Prapa; Komsakorn, Sitijate; Wattanaamornkiet, Wanpen; Moolphate, Saiyud; Chiengsorn, Navarat; Kaewsa-ard, Samroui; Nateniyom, Sriprapa; Varma, Jay K.

doi:10.1111/j.1365-3156.2009.02376.x

Cited by 10 publications

(12 citation statements)

References 22 publications

(30 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The rate of successful treatment outcome was also lowest in the rifampicin resistant group. The current findings are consistent with the finding reported in Tak province, Thailand, and also concurrent with existing literature on TB drug resistance and higher death rate ( Amnuaiphon et al, 2009 ; Hemhongsa et al, 2008 , WHO, 2010 ).…”

Section: Discussionsupporting

confidence: 93%

“…Globally, patients with MDR-TB have lower cure rates and higher mortality rates than patients with drug-susceptible TB ( Mitnick et al, 2003 ; Nathanson et al, 2006 ). This is also true in Thailand, where MDR-TB has a significant association with mortality rate both in HIV-infected and HIV-uninfected TB patients ( Maranetra, 1996 ; Amnuaiphon et al, 2009 ; Sanguanwongse et al, 2008 ).…”

Section: Introductionmentioning

confidence: 82%

See 1 more Smart Citation

Effect of Mycobacterial Drug Resistance Patterns on Patients’ Survival: A Cohort Study in Thailand

Anuwatnonthakate

Whitehead

Varma³

et al. 2013

GJHS

Self Cite

View full text Add to dashboard Cite

Background:Drug resistance substantially increases tuberculosis (TB) mortality. This study aimed to describe the prevalence of mycobacterial drug resistance pattern and association of common resistance patterns with TB mortality in Thailand.Method:A retrospective cohort study was conducted using TB surveillance data. A total of 9,518 culture-confirmed, pulmonary TB patients registered from 1 October 2004 to 31 December 2008 from the Thailand TB Active Surveillance Network were included in this study. Patients were followed up until TB treatment completion or death. Mycobacterial drug resistance patterns were categorized as pan-susceptible, rifampicin resistance, isoniazid monoresistance, and ethambutol/streptomycin resistance. Drug susceptibility testing (DST) was determined by Mycobacterial Growth Indicator Tube (MGIT) liquid culture systems. Survival analysis was applied.Result:Isoniazid monoresistance was the most common pattern, while rifampicin resistance had the largest impact on mortality. Cox regression analysis showed a significantly higher risk of death among patients with rifampicin resistance (adjusted hazard ratio (aHR) 1.9, 95% confident interval (CI), 1.5-2.5) and isoniazid monoresistance (aHR 1.4, 95% CI 1.1-1.7) than those with pan-susceptible group after adjustment for age, nationality, human immunodeficiency virus (HIV) and antiretroviral therapy (ART) status, diabetes mellitus, cavitary disease on chest x-ray, treatment observation, and province. HIV co-infection was associated with higher mortality in patients both on ART (aHR 1.9, 95% CI 1.5-2.5) and not on ART (aHR 8.1, 95% CI 6.8-9.8).Conclusion:Rifampicin resistance and isoniazid monoresistance were associated with increased TB mortality. HIV-coinfection was associated with a higher risk of death including among those taking antiretroviral therapy.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 82%

Effect of Mycobacterial Drug Resistance Patterns on Patients’ Survival: A Cohort Study in Thailand

Anuwatnonthakate

Whitehead

Varma³

et al. 2013

GJHS

Self Cite

View full text Add to dashboard Cite

show abstract

“…We have demonstrated that older age contributes to an increase in relative risk of death independent of HIV status, a finding consistent with previous studies [10]. This may be due to concomitant pathology, less physical reserves or it may reflect an increasing frequency of non-TB causes of death.…”

Section: Discussionsupporting

confidence: 91%

The complex relationship between human immunodeficiency virus infection and death in adults being treated for tuberculosis in Cape Town, South Africa

et al. 2015

View full text Add to dashboard Cite

BackgroundDespite recognised treatment strategies, mortality associated with tuberculosis (TB) remains significant. Risk factors for death during TB treatment have been described but the complex relationship between TB and HIV has not been fully understood.MethodsA retrospective analysis of all deaths occurring during TB treatment in Cape Town, South Africa between 2009 and 2012 were done to investigate risk factors associated with this outcome. The main risk factor was HIV status at the start of treatment and its interaction with age, sex and other risk factors were evaluated using a binomial regression model and thus relative risks (RR) are reported.ResultsOverall in the 93,133 cases included in the study 4619 deaths (5 %) were recorded. Across all age groups HIV-positive patients were more than twice as likely to die as HIV-negative patients, RR = 2.19 (95 % CI: 2.03–2.37). However in an age specific analysis HIV-positive patients 15–24 and 25–34 years old were at an even higher risk of dying than HIV-negative patients, RR = 4.82 and RR = 3.76 respectively. Gender also modified the effect of HIV- with positive women having a higher risk of death than positive men, RR = 2.74 and RR = 1.94 respectively.ConclusionHIV carries an increased risk of death in this study but specific high-risk groups pertaining to the impact of HIV are identified. Innovative strategies to manage these high risk groups may contribute to reduction in HIV-associated death in TB patients.

show abstract

“…Bacteriological factors related to causal organism like culture positivity, drug resistance, and multidrug-resistant TB (MDR-TB) were not significant factors in the current study. However, previous studies in Thailand and Europe reported that MDR-TB was a significant risk for overall TB death 7,19. The different finding could be due to a different time point of analysis and low level of MDR-TB prevalence in Chiang Rai.…”

Section: Discussionmentioning

confidence: 85%

“…Previous studies in various regions of the world reported high risk for elderly TB patients, but the risk was not specified for death in the first month 7,11,14–19. Recently, analysis of TB surveillance data from 15 European Union (EU) countries during 2002–2004 reported that advancing age and resistance to isoniazid and rifampicin were the strongest risks of TB death 19.…”

Section: Discussionmentioning

confidence: 99%

Time of highest tuberculosis death risk and associated factors: an observation of 12 years in Northern Thailand

Aung¹,

Moolphate²,

Nampaisan³

et al. 2011

IJGM

View full text Add to dashboard Cite

Purpose:Northern Thailand is a tuberculosis (TB) endemic area with a high TB death rate. We aimed to establish the time of highest death risk during TB treatment, and to identify the risk factors taking place during that period of high risk.Patients and methods:We explored the TB surveillance data of the Chiang Rai province, Northern Thailand, retrospectively for 12 years. A total of 19,174 TB patients (including 5,009 deaths) were investigated from 1997 to 2008, and the proportion of deaths in each month of TB treatment was compared. Furthermore, multiple logistic regression analysis was performed to identify the characteristics of patients who died in the first month of TB treatment. A total of 5,626 TB patients from 2005 to 2008 were included in this regression analysis.Result:The numbers of deaths in the first month of TB treatment were 38%, 39%, and 46% in the years 1997–2000, 2001–2004, and 2005–2008, respectively. The first month of TB treatment is the time of the maximum number of deaths. Moreover, advancing age, HIV infection, and being a Thai citizen were significant factors contributing to these earlier deaths in the course of TB treatment.Conclusion:Our findings have pointed to the specific time period and patients at higher risk for TB death. These findings would be useful for prioritizing interventions in order to diminish TB-related deaths globally. Studies based on these findings are necessary for the introduction of newer intervention strategies.

show abstract

Factors associated with death among HIV‐uninfected TB patients in Thailand, 2004–2006

Cited by 10 publications

References 22 publications

Effect of Mycobacterial Drug Resistance Patterns on Patients’ Survival: A Cohort Study in Thailand

Effect of Mycobacterial Drug Resistance Patterns on Patients’ Survival: A Cohort Study in Thailand

The complex relationship between human immunodeficiency virus infection and death in adults being treated for tuberculosis in Cape Town, South Africa

Time of highest tuberculosis death risk and associated factors: an observation of 12 years in Northern Thailand

Contact Info

Product

Resources

About