Factors associated with mortality from tuberculosis in Iran: an application of a generalized estimating equation-based zero-inflated negative binomial model to national registry data

Sarvi, Fatemeh; Moghimbeigi, Abbas; Mahjub, Hossein; Mahshid, Nasehi; Khodadost, Mahmoud

doi:10.4178/epih.e2019032

Cited by 3 publications

(2 citation statements)

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“…Most studies evaluating risk factors associated with TB mortality, severe morbidity or unsuccessful treatment in PLWH typically focus on factors related to the host, such as male sex (17)(18)(19)(20)(21), advanced age (8,12,17,20,(22)(23)(24)(25), co-morbidities (8, 23,24,[26][27][28][29][30][31][32][33][34][35], poor adherence to treatment (24,32,36,37), smoking (26,38), alcohol use (29,31,32) or low socio-economic level (38,39). Very few studies focused on important characteristics of the TB disease itself such as bacillary load (8,22,40), extent of lung involvement on chest x-ray (36, [41][42][43], or disease dissemination (17,44,45).…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis disease characteristics associated with mortality, severe morbidity and unsuccessful treatment in people living with HIV treated for tuberculosis – a secondary analysis of the ANRS 12300 Reflate TB2 trial

AKPATA,

N'Takpe,

MESSOU

et al. 2024

Preprint

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Background Tuberculosis is a severe disease, not only due to its lethality but also to a significant morbidity occurring in people living with HIV (PLWH). If factors associated to mortality, severe morbidity and unsuccessful treatment related to the host are well identified in PLWH, there is scarce knowledge on factors related to the disease itself such as bacillary load, extent of lung involvement and disease dissemination to other organs. We sought to assess whether tuberculosis-related factors were associated with key patient outcomes in PLWH using data from an international clinical trial. Methods We conducted a secondary analysis of the ANRS 12300 Reflate TB2 international phase III open-label randomized trial that assessed different antiretroviral regimens in PLWH treated for tuberculosis. We evaluated whether bacillary load (smear positivity grade), extent of lung involvement (cavitation on chest x-ray) and disease dissemination (urine LAM positivity) were associated with mortality using Cox proportional hazard models and to severe morbidity and unsuccessful tuberculosis treatment using logistic regressions. Results Of 457 participants included in this study, 90 (20.4%) had grade 2 + or 3 + smear positivity, 39 (10.8%) had cavitation on chest X-ray, and 147 (32.2%) had a positive urinary LAM. Overall, 19 (4.2%) participants died, 113 (24.7%) presented severe morbidity, and 33 (7.2%) had unsuccessful tuberculosis treatment. Factors that remained independently associated with mortality were cavitation on chest x-ray (aHR = 7.92, 95% CI, 1.74–35.94, p = .0073) and LAM positivity (aHR = 5.53, 95% CI, 1.09–28.06, p = .0389). The only factor that remained significantly associated with severe morbidity was LAM positivity (aOR = 2.04, 95% CI, 1.06–3.92, p = .0323). No factor remained significantly associated with unsuccessful tuberculosis treatment. Conclusions In PLWH with tuberculosis enrolled in a trial, tuberculosis disease characteristics related to disease severity were cavitation on chest x-ray and urine LAM positivity. Early identification of these factors could help improve the management of PLWH with tuberculosis and improve their survival.

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Section: Introductionmentioning

confidence: 99%

Tuberculosis disease characteristics associated with mortality, severe morbidity and unsuccessful treatment in people living with HIV treated for tuberculosis – a secondary analysis of the ANRS 12300 Reflate TB2 trial

AKPATA,

N'Takpe,

MESSOU

et al. 2024

Preprint

View full text Add to dashboard Cite

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“…In this study, we scrutinised the demographic and epidemiological characteristics of scorpion stings in the Touggourt region and we presented a best fit model to forecast the daily scorpion sting counts in that region using climate variables. The approach used herein has been applied in several studies related to other health issues [20][21][22][23][24][25], but this is the first time it has been applied to daily scorpion stings.…”

Section: Introductionmentioning

confidence: 99%

Demographic and epidemiological characteristics of scorpion envenomation and daily forecasting of scorpion sting counts: the case of Touggourt in Algeria

2020

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This study was conducted to provide better insights into the demographic and epidemiological characteristics of scorpion envenomation in an endemic area in Algeria and to identify the model that best predicted daily scorpion sting counts. METHODS:Daily sting data from January 1, 2013 to August 31, 2016 were extracted from questionnaires designed to elicit information on scorpion stings from the two emergency medical service providers in Touggourt, Algeria. Count regression models were applied to the daily sting data. RESULTS:A total of 4,712 scorpion sting cases were documented, of which 70% occurred in people aged between 10 years and 49 years. The male-to-female ratio was 1.3. The upper and lower limbs were the most common locations of scorpion stings (90.4% of cases). Most stings (92.8%) were mild. The percent of people stung inside dwellings was 68.8%. The hourly distribution of stings showed a peak between 10:00 a.m. and 11:00 a.m. The daily number of stings ranged from 0 to 24. The occurrence of stings was highest on Sundays. The incidence of scorpion stings increased sharply in the summer. The mean annual incidence rate was 542 cases per 100,000 inhabitants. The fitted count regression models showed that a negative binomial hurdle model was appropriate for forecasting daily stings in terms of temperature and relative humidity, and the fitted data agreed considerably with the actual data. CONCLUSIONS:This study showed that daily scorpion sting data provided meaningful insights; and the negative binomial Hurdle model was preferable for predicting daily scorpion sting counts.

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Impact of socio-economic inequities on tuberculosis in a Southern European city: what is the effect of the recession?

Prats‐Uribe

Orcau

Millet

et al. 2019

int j tuberc lung dis

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Introduction: Economic crises affect the population's health, especially among the most deprived. The increase in health inequalities in this recession may have influenced the incidence of tuberculosis (TB). We analyzed the effect of socioeconomic inequities and the recession on the incidence of TB. Methods: We conducted a population-based incidence study of TB cases in Barcelona, Spain, who started treatment between 2003 and 2015. A multilevel interrupted time series analysis was done to analyze differences in incidence trends between the pre-recession (until 2008) and recession periods. Results: We observed differences in TB incidence according to deprivation and immigration status. TB incidence among most deprived neighborhoods was 2.72 times higher than least deprived. Compared to natives, incidence was 9 times higher among those born in Africa, and 6 times higher among those born in Asia and Oceania. The previous decreasing trend in incidence (4%) was accentuated during the recession (7%). Conclusions: The incidence of TB decreased during the recession, probably due to a reduction of new immigrants and the TB programme. However, incidence is highly unequal between districts with different levels of deprivation, and between foreign-born from different geographical regions. Social measures are important for reducing inequalities and TB incidence in Barcelona.

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Factors associated with mortality from tuberculosis in Iran: an application of a generalized estimating equation-based zero-inflated negative binomial model to national registry data

Cited by 3 publications

References 35 publications

Tuberculosis disease characteristics associated with mortality, severe morbidity and unsuccessful treatment in people living with HIV treated for tuberculosis – a secondary analysis of the ANRS 12300 Reflate TB2 trial

Tuberculosis disease characteristics associated with mortality, severe morbidity and unsuccessful treatment in people living with HIV treated for tuberculosis – a secondary analysis of the ANRS 12300 Reflate TB2 trial

Demographic and epidemiological characteristics of scorpion envenomation and daily forecasting of scorpion sting counts: the case of Touggourt in Algeria

Impact of socio-economic inequities on tuberculosis in a Southern European city: what is the effect of the recession?

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