Survival of smear-positive multidrug resistant tuberculosis patients in Witbank, South Africa: A retrospective cohort study

Olaleye, Abiola O; Beke, Andy

doi:10.3109/23744235.2016.1153806

Cited by 10 publications

(12 citation statements)

References 10 publications

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“…HIV-infected patients were 5.7 times more at risk to die while on MDR-TB treatment. This is in line with findings in the Amhara Region of Ethiopia, SNNPR, Ethiopia, South Africa, and Latvia [ 5 , 8 , 12 , 22 , 23 ]. HIV/AIDS might compromise their immunity and lead to poor prognosis of their health status.…”

Section: Discussionsupporting

confidence: 92%

Survival Status and Predictors of Mortality among Multidrug-Resistant Tuberculosis Patients in Saint Peter’s Specialized Hospital, Addis Ababa, Ethiopia

Muluneh

Zeru

Derseh

et al. 2021

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. Multidrug-Resistant Tuberculosis (MDR-TB) is tuberculosis that is resistant to at least both rifampicin and isoniazid. The World Health Organization as reported in 2019 revealed that Ethiopia is among the 20 countries with the highest estimated numbers of incident MDR-TB cases. However, supporting evidence is limited in the study area after the Ethiopian national strategic plan for tuberculosis prevention and control is started. Objective. To determine survival status and predictors of mortality among multidrug-resistant tuberculosis patients treated in Saint Peter’s Specialized Hospital at Addis Ababa, Ethiopia, 2020. Methods. An institutional retrospective cohort study was conducted using all MDR-TB patients who were enrolled in Saint. Peter’s Specialized Hospital from January 01, 2015, to December 31, 2017. A pretested data extraction form that had 5 items for sociodemographic and 15 items for the measurement of clinical characteristics of 484 MDR-TB patients was used. STATA software version 14.2 was used for data cleaning and analysis. A variable that fitted in the bivariable Cox proportional hazard model at p value <0.25 was used in the final multivariable Cox proportional hazard model, and independent predictors of time to event were determined at a p value of 0.05. Result. A total of 484 patients were followed up for 5,078 person-months. Among the total patients, nearly half, 238 (48.8%), were males. The median age of patients was 30 years (interquartile range (IQR), 24–39), and 56 (11.6%) were aged between 1 and 19 years. During the follow-up period, 315 (65.1%) patients were cured, 125 (25.8%) completed treatment, 24 (5%) died, and 20 (4.1%) were lost to follow-up. The overall cumulative probability survival of the patients at the end of treatment was 94.85% (95% confidence interval (CI): 92.38%–96.53%). The independent predictors of time to death were being anemic (AHR = 3.65; 95% CI: 1.36, 9.79), having clinical complication (AHR = 3; 95% CI: 1.2, 7.5), and being HIV infected (AHR = 5.8; 95% CI: 2.2, 15.7). Conclusions. MDR-TB patients’ survival rate was high in St Peter’s Specialized Hospital. MDR-TB patients with anemia, HIV coinfection, and clinical complications had higher risk of mortality. So, prevention and controlling of anemia, HIV/AIDS, and clinical complications will reduce the mortality of MDR-TB patients.

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Section: Discussionsupporting

confidence: 92%

Survival Status and Predictors of Mortality among Multidrug-Resistant Tuberculosis Patients in Saint Peter’s Specialized Hospital, Addis Ababa, Ethiopia

Muluneh

Zeru

Derseh

et al. 2021

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…patients with various comorbid conditions while on SLD therapy was variably increased by 1.96 (95% CI: 1.35-3.85), 2.33 (95% CI: 1.34-4.05), 2.6 (95% CI: 1.82-3.70), 5.42 (95% CI: 2.66-11.04), and 6.82 (95% CI: 2.16-21.50) folds [9,12,80,83]. Again, several other studies indicated a varied but increased likelihood of mortality by 1.46 (95% CI: 1.05-1.96), 1.50 (95% CI: 1.20-1.90), 1.70 (95% CI: 1.20-3.10), 1.89 (95% CI: 1.02-3.52), 2.97 (95% CI: 1.41-6.24), 3.18 (95% CI: 1.05-9.69), 3.47 (95% CI: 1.02-11.64), 4.22 (95% CI: 2.65-6.72), and 5.6 (95% CI: 3.2-9.7) times higher among the HIV-infected patients than HIV-uninfected ones [83][84][85][86][87][88][89][90][91]. A meta-analysis also reported 1�8 (95% CI: 1�5-2�2) times higher odds of mortality among the HIV-positive patients on antiretroviral therapy (ART) than those who did not receive the ART [92], but majorities of the studies included in our review did not report mortality by the ART status and we were unable to explore this difference by the ART treatment.…”

Section: Plos Onementioning

confidence: 98%

Incidence and predictors of mortality among persons receiving second-line tuberculosis treatment in sub-Saharan Africa: A meta-analysis of 43 cohort studies

et al. 2021

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Background Drug resistance remains from among the most feared public health threats that commonly challenges tuberculosis treatment success. Since 2010, there have been rapid evolution and advances to second-line anti-tuberculosis treatments (SLD). However, evidence on impacts of these advances on incidence of mortality are scarce and conflicting. Estimating the number of people died from any cause during the follow-up period of SLD as the incidence proportion of all-cause mortality is the most informative way of appraising the drug-resistant tuberculosis treatment outcome. We thus aimed to estimate the pooled incidence of mortality and its predictors among persons receiving the SLD in sub-Saharan Africa. Methods We systematically identified relevant studies published between January, 2010 and March, 2020, by searching PubMed/MEDLINE, EMBASE, SCOPUS, Cochrane library, Google scholar, and Health Technology Assessment. Eligible English-language publications reported on death and/or its predictors among persons receiving SLD, but those publications that reported death among persons treated for extensively drug-resistant tuberculosis were excluded. Study features, patients’ clinical characteristics, and incidence and/or predictors of mortality were extracted and pooled for effect sizes employing a random-effects model. The pooled incidence of mortality was estimated as percentage rate while risks of the individual predictors were appraised based on their independent associations with the mortality outcome. Results A total of 43 studies were reviewed that revealed 31,525 patients and 4,976 deaths. The pooled incidence of mortality was 17% (95% CI: 15%-18%; I2 = 91.40; P = 0.00). The studies used varied models in identifying predictors of mortality. They found diagnoses of clinical conditions (RR: 2.36; 95% CI: 1.82–3.05); excessive substance use (RR: 2.56; 95% CI: 1.78–3.67); HIV and other comorbidities (RR: 1.96; 95% CI: 1.65–2.32); resistance to SLD (RR: 1.75; 95% CI: 1.37–2.23); and male sex (RR: 1.82; 95% CI: 1.35–2.44) as consistent predictors of the mortality. Few individual studies also reported an increased incidence of mortality among persons initiated with the SLD after a month delay (RR: 1.59; 95% CI: 0.98–2.60) and those persons with history of tuberculosis (RR: 1.21; 95% CI: 1.12–1.32). Conclusions We found about one in six persons who received SLD in sub-Saharan Africa had died in the last decade. This incidence of mortality among the drug-resistant tuberculosis patients in the sub-Saharan Africa mirrors the global average. Nevertheless, it was considerably high among the patients who had comorbidities; who were diagnosed with other clinical conditions; who had resistance to SLD; who were males and substance users. Therefore, modified measures involving shorter SLD regimens fortified with newer or repurposed drugs, differentiated care approaches, and support of substance use rehabilitation programs can help improve the treatment outcome of persons with the drug-resistant tuberculosis. Trial registration number CRD42020160473; PROSPERO

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“…Second, some possible factors were not verified in our study, such as delayed time for diagnosis, drug resistance status, education level of patients, smoking status, and comorbidity of HIV. 21 , 34 , 35 Meanwhile, some explorations in clinical data such as radiologic severity and drug adverse effects were not considered. We, however, investigated three different survival periods providing the dynamic characteristics of associated factors, which contributed to a better understanding of PTB survival features.…”

Section: Discussionmentioning

confidence: 99%

Survival Analysis and Associated Factors for Pulmonary Tuberculosis Death: Evidence from the Information System of Tuberculosis Disease and Mortality Surveillance in China

Liu¹,

Ai²,

Jin³

et al. 2022

RMHP

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Background Pulmonary tuberculosis (PTB) is a severe infection, and its factors that influence survival have not been explored in some developed regions. Therefore, this study aimed to identify the factors that influence TB survival in China. Methods We acquired data of PTB deaths through matching two manage systems of PTB and mortality surveillance. The Kaplan–Meier method and Cox regression model were used to identify the significant factors under various survival times. Results A total of 283 deaths were caused by PTB, in which 53.4% occurred during the first year. In the Cox regression model, regular sputum smear test could reduce the risk of PTB death from the result of one-, three-, and five-year survival; and history of PTB treatment could decline the risk of PTB death in the first year. Additionally, age of “75–90 years” and positive result of sputum smear test significantly increased the risk of PTB death for the findings of three- and five-year survival, while age of “60–75 years” could increase the probability of PTB death for five-year survival. Conclusion To reduce PTB deaths, more attention should be paid to the older group especially in the first year. Regular sputum smear test could effectively reduce the mortality of PTB cases. More evidence-based interventions should be implemented to enhance the survival of patients with PTB.

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Survival of smear-positive multidrug resistant tuberculosis patients in Witbank, South Africa: A retrospective cohort study

Abstract: Background: A retrospective cohort study was carried out to compare the survival between

Cited by 10 publications

References 10 publications

Survival Status and Predictors of Mortality among Multidrug-Resistant Tuberculosis Patients in Saint Peter’s Specialized Hospital, Addis Ababa, Ethiopia

Survival Status and Predictors of Mortality among Multidrug-Resistant Tuberculosis Patients in Saint Peter’s Specialized Hospital, Addis Ababa, Ethiopia

Incidence and predictors of mortality among persons receiving second-line tuberculosis treatment in sub-Saharan Africa: A meta-analysis of 43 cohort studies

Survival Analysis and Associated Factors for Pulmonary Tuberculosis Death: Evidence from the Information System of Tuberculosis Disease and Mortality Surveillance in China

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