Predictors for Mortality among Multidrug-Resistant Tuberculosis Patients in Tanzania

Abstract

Problem Factors related to MDRTB mortality in Tanzania have not been adequately explored and reported. Objectives To determine demographic, clinical, radiographic, and laboratory factors associated with MDRTB mortality in a Tanzanian TB Referral Hospital. Methodology This was a cross-sectional study with 193 participants. Demographic, clinical, laboratory, and radiological data were collected, and their associations with mortality among MDRTB patients were determined. Results and Conclusions Cough was the commonest finding among these MDRTB patients, with 179 (92.75%) of them presenting with cough, followed by chest X-ray consolidation in 156 patients (80.83%) and history of previous TB treatment in 151 patients (78.24%). Cigarette smoking, HIV positivity, and low CD4 counts were significantly associated with MDRTB mortality, p values of 0.034, 0.044, and 0.048, respectively. Fever on the other hand was at the borderline with p value of 0.059. We conclude that cigarette smoking and HIV status are significant risk factors for mortality among MDRTB patients. HIV screening should continually be emphasized among patients and the general community for early ARTs initiation. Based on the results from our study, policy makers and public health personnel should consider addressing tobacco cessation as part of national TB control strategy.

Risk factors for mortality among drug-resistant tuberculosis patients registered for drug-resistant treatment in Amhara region, Ethiopia: a historical cohort study

“…This study found that incidence of mortality was 8.2 per 1000 person-months observation. This finding was comparable with previous studies conducted in Ethiopia [14,18], and other countries in sub-Saharan Africa [23]. In contrary, our finding was higher compared to the research conducted in St. Peter specialized TB hospital in Addis Ababa which is 3.6 per 10,000 person-days [13].…”

“…Therefore, understanding risk factors for DR-TB mortality is vital to improving DR-TB treatment outcomes. Previous studies have shown that increasing age [15,16], smoking cigarette [17,18], comorbidities [19][20][21] such as HIV/AIDS and diabetes, clinical complication [14,21,22] therapeutic delay [3,23,24] were contributing factors for DR-TB mortality .…”

Risk factors for tuberculosis: diabetes, smoking, alcohol use, and the use of other drugs

“… 25 One recent study showed that smoking and HIV infection were significant risk factors for mortality in patients with MDR-TB. 26 When smokers quit smoking, the risk of death due to tuberculosis drops significantly (by 65% compared with that observed for those who continue smoking), which indicates that smoking cessation is an important factor in reducing tuberculosis-related mortality. 25 …”

Health Belief Model and PRECEDE PROCEED on the Risk Factors of Multidrug Resistant Tuberculosis in Surakarta, Central Java

“…It is found that smoking reduces body immune. Not only it worsens the TB condition to become resistant to medications, it also leads to the risk of recurrence when TB has been treated (Mollel and Chilongola, 2017). As the result of severity level on smoking group, it may generate the increasing risk of resistance to medications therefore it increase mortality rate.…”