Factors Associated with Mortality in Tuberculosis Patients at Debre Birhan Referral Hospital, Ethiopia: A Retrospective Study

Woldeamanuel, Gashaw Garedew; Mingude, Alemu Basazin

doi:10.4172/2329-891x.1000289

Cited by 3 publications

(2 citation statements)

References 25 publications

(42 reference statements)

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“…In contradiction to this finding, other studies reported that the place of residence was not significantly associated with death. 15,23 In the present study, patients aged ≥45 years (HR = 5.32, 95% CI: 1.23-22.96) had a lower survival rate as compared to the younger age groups. A wider confidence interval of hazard ratio for age was observed.…”

Section: Discussionmentioning

confidence: 47%

<p>Modeling the Survival of Tuberculosis Patients in Eastern Zone of Tigray Regional State</p>

Geleso¹

2020

RMHP

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Background: Tuberculosis (TB) is still a public health problem and amongst the top ten leading causes of death. The aim of this paper was to identify the factors that significantly affect the survival of tuberculosis patients. Methods: A retrospective cohort study was carried out in Adigrat General and Wukro hospitals, Eastern Zone of Tigray region, Ethiopia. Data for this study were obtained from medical records of all TB cases registered from September 2016 to August 2017 in the two hospitals. Log-rank test and Kaplan-Meier plot were used to evaluate the survival pattern of TB patients. A multivariable Cox proportional regression model was employed to identify the predictors of mortality. Factors with a P-value smaller than 0.05 were taken as statistically significant facilitators of TB death. Results: Of the 397 patients studied over the specified period, 23 (5.8%) had died. A statistically significant survival difference was observed among gender, residence, HIV status, treatment category, and age category of patients. In multivariable cox regression, lower survival rates were observed among patients aged ≥45 years (HR = 5.315, 95% CI: 1.231-22.959), relapse cases (HR = 4.069, 95% CI: 1.636-10.119), patients with extrapulmonary TB (HR = 3.054, 95% CI: 1.044-8.940), patients from rural areas (HR = 2.834, 95% CI: 1.161-6.916), patients with a bodyweight of ≤50 kg and HIV-positive patients. Conclusion: Based on the survival experience of TB patients, advancing age, extrapulmonary TB infection, living in rural residence, lower bodyweight at beginning of treatment, HIV coinfection, and being a retreatment patient were predictors of mortality. To achieve the "End TB Strategy" goal of zero death, proper targeting of care to these vulnerable groups should be advised.

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Section: Discussionmentioning

confidence: 47%

<p>Modeling the Survival of Tuberculosis Patients in Eastern Zone of Tigray Regional State</p>

Geleso¹

2020

RMHP

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“…The proportion of the EPTB varied from 8% [26] to 25% [60]. With regard to HIV infection status among TB patients, the HIV-positive ranged from 2% [25] to 44% [53], HIVnegative ranged from 4% [27] to 95% [24], and unknown HIV status ranged from 1% [24] to 90% [27].…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Unknown HIV status and the TB/HIV collaborative control program in Ethiopia: systematic review and meta-analysis

et al. 2020

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Background: Ethiopia has shown significant efforts to address the burden of TB/HIV comorbidity through the TB/ HIV collaborative program. However, these diseases are still the highest cause of death in the country. Therefore, this systematic review and meta-analysis evaluated this program by investigating the overall proportion of unknown HIV status among TB patients using published studies in Ethiopia. Methods: We conducted a systematic review and meta-analysis of published studies in Ethiopia. We identified the original studies using the databases MEDLINE/PubMed, and Google Scholar. The heterogeneity across studies was assessed using Cochran's Q test and I 2 statistics. The Begg's rank correlation and the Egger weighted regression tests were assessed for the publication bias. We estimated the pooled proportion of unknown HIV status among TB patients using the random-effects model. Results: Overall, we included 47 studies with 347,896 TB patients eligible for HIV test. The pooled proportion of unknown HIV status among TB patients was 27%(95% CI; 21-34%) and with a substantial heterogeneity (I 2 = 99.9%). In the subgroup analysis, the pooled proportion of unknown HIV status was 39% (95% CI; 25-54%) among children and 20% (95% CI; 11-30%) among adults. In the region based analysis, the highest pooled proportion of unknown HIV status was in Gambella, 38% (95% CI; 16-60%) followed by Addis Ababa, 34%(95% CI; 12-55%), Amhara, 30%(95% CI; 21-40%),and Oromia, 23%(95% CI; 9-38%). Regarding the study facilities, the pooled proportion of unknown HIV status was 33% (95% CI; 23-43%) in the health centers and 26%(95% CI; 17-35%) in the hospitals. We could not identify the high heterogeneity observed in this review and readers should interpret the results of the pooled proportion analysis with caution. Conclusion: In Ethiopia, about one-third of tuberculosis patients had unknown HIV status. This showed a gap to achieve the currently implemented 90-90-90 HIV/AIDS strategic plan in Ethiopia, by 2020. Therefore, Ethiopia should strengthen TB/HIV collaborative activities to mitigate the double burden of diseases.

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Treatment outcomes of patients with drug-sensitive tuberculosis under community-based versus facility-based directly observed treatment, short course strategy in Southwest Ethiopia: a prospective cohort study

et al. 2021

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ObjectiveTo compare tuberculosis (TB) treatment outcomes and associated factors among patients attending community-based versus facility-based directly observed treatment, short course (DOTS).DesignA prospective cohort study.SettingThe study was conducted in Southwest Ethiopia. There were seven hospitals (five primary, one general and one specialised), 120 health centres and 494 health posts.ParticipantsA total of 1161 individuals consented to participate in the study (387 patients under community-based DOTS (CB-DOTS) and 774 patients under facility-based DOTS (FB-DOTS)). Individuals who could not respond to the questions, mentally or critically ill patients, and those less than 15 years old, were excluded from the study.Primary outcome measureTB treatment outcomes were compared among patients under CB-DOTS versus FB-DOTS. Risk ratio (RR), risk difference (RD) and confidence interval (CI) were calculated among the study groups. In addition, χ2 or Fisher’s exact tests were used to compare group differences, with a p value of <0.05 considered statistically significant.ResultsPatients who opted for CB-DOTS were more likely to be cured by 12% than those who opted for FB-DOTS (RR=1.12, 95% CI=0.96 to 1.30). Patients under CB-DOTS had a lesser risk of death (RR=0.93, 95% CI=0.49 to 1.77) and a lower risk of treatment failure (RR=0.86, 95% CI=0.22 to 3.30) than those under FB-DOTS. Furthermore, patients who opted for CB-DOTS were less likely to have a positive sputum smear result at the end of the treatment period (p=0.042) compared with their counterparts.ConclusionThe study showed that CB-DOTS is more effective than FB-DOTS in terms of improving cure rate and sputum conversion rate, as well as lowering treatment failure rate. Our findings show the need for scaling up and a further decentralisation of CB-DOTS approach to improve access to TB treatment service for the rural community.

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Factors Associated with Mortality in Tuberculosis Patients at Debre Birhan Referral Hospital, Ethiopia: A Retrospective Study

Cited by 3 publications

References 25 publications

<p>Modeling the Survival of Tuberculosis Patients in Eastern Zone of Tigray Regional State</p>

<p>Modeling the Survival of Tuberculosis Patients in Eastern Zone of Tigray Regional State</p>

Unknown HIV status and the TB/HIV collaborative control program in Ethiopia: systematic review and meta-analysis

Treatment outcomes of patients with drug-sensitive tuberculosis under community-based versus facility-based directly observed treatment, short course strategy in Southwest Ethiopia: a prospective cohort study

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