scholarly journals Factors associated with death in patients with tuberculosis in Brazil: survival analysis with competitive risks

2019 ◽  
Author(s):  
Paulo Victor de Sousa Viana ◽  
Natalia Santana Paiva ◽  
Daniel Antunes Maciel Villela ◽  
Leonardo Soares Bastos ◽  
Ana Luiza de Souza Bierrenbach ◽  
...  
Keyword(s):  
Causes Of Death ◽  
Population Based ◽  
High Rate ◽  
Hiv Positive ◽  
Death Certificates ◽  
Positive Serology ◽  
Tuberculosis Patients ◽  
Factors Associated ◽  
Tb Treatment ◽  
Early Case

Abstract Background: This study aimed to analyze the factors associated with deaths caused by TB, TB-related causes and deaths from other causes. Methods: A retrospective, population-based cohort study of the causes of death, using a survival regression model in the presence of competitive risk in a cohort of patients in treatment for TB was performed using records of patients that started TB treatment in Brazil and death certificates from 2008 to 2013. Results: In this cohort, 39,997 individuals (14.1%) died, out of a total of 283,508 individuals. Of these, 8,936 deaths due to TB (22.4%), 3,365 deaths to associated TB (8.4%), revealing a high rate of lethality. 27,696 deaths (69.2%) were from other causes. From our analysis, factors strongly associated with death from TB were male gender (sHR = 1.33, 95% CI: 1.26-1.40), older than 60 years (sHR = 9.29, 95% CI: 8.15-10.60), illiterate schooling (sHR = 2.33, 95% CI: 2.09-2.59), black (sHR = 1.33, 95% CI: 1.26-1.40) and brown color/race (sHR = 13, 95% CI: 1.07-1.19), from the southern region (sHR = 1.19, 95% CI: 1.10-1.28), mixed forms (sHR = 1.91, 95% CI: 1.73 -2.11) and alcoholism (sHR = 1.90, 95% CI: 1.81-2.00). Also, HIV positive serology was strongly associated with death due to TB (sHR = 62.78; 95% CI: 55.01 - 71.63). Conclusions: We believe that specific active surveillance strategies and early case finding could reduce mortality among tuberculosis patients, leading to a more timely detection and treatment.

scholarly journals Factors associated with death in patients with tuberculosis in Brazil: survival analysis with competitive risks

2019 ◽  
Author(s):  
Paulo Victor de Sousa Viana ◽  
Natalia Santana Paiva ◽  
Daniel Antunes Maciel Villela ◽  
Leonardo Soares Bastos ◽  
Ana Luiza de Souza Bierrenbach ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Population Based ◽  
High Rate ◽  
Hiv Positive ◽  
Positive Serology ◽  
Tuberculosis Patients ◽  
Factors Associated ◽  
Tb Treatment ◽  
Keywords Tuberculosis ◽  
Early Case

Abstract Background: This study aimed to analyze the factors associated with deaths caused by TB, TB-related causes and deaths from other causes. Methods: A retrospective, population-based cohort study of the causes of death, using a survival regression model in the presence of competitive risk in a cohort of patients in treatment for TB was performed using records of patients that started TB treatment in Brazil and death certificates from 2008 to 2013. Results: In this cohort, 39,997 individuals (14.1%) died, out of a total of 283,508 individuals. Of these, 8,936 deaths due to TB (22.4%), 3,365 deaths to associated TB (8.4%), revealing a high rate of lethality. 27,696 deaths (69.2%) were from other causes. From our analysis, factors strongly associated with death from TB were male gender (sHR = 1.33, 95% CI: 1.26-1.40), older than 60 years (sHR = 9.29, 95% CI: 8.15-10.60), illiterate schooling (sHR = 2.33, 95% CI: 2.09-2.59), black (sHR = 1.33, 95% CI: 1.26-1.40) and brown color/race (sHR = 13, 95% CI: 1.07-1.19), from the southern region (sHR = 1.19, 95% CI: 1.10-1.28), mixed forms (sHR = 1.91, 95% CI: 1.73 -2.11) and alcoholism (sHR = 1.90, 95% CI: 1.81-2.00). Also, HIV positive serology was strongly associated with death due to TB (sHR = 62.78; 95% CI: 55.01 - 71.63). Conclusions: We believe that specific active surveillance strategies and early case finding could reduce mortality among tuberculosis patients, leading to a more timely detection and treatment. Keywords: tuberculosis; death surveillance; survival analysis; competitive risk analysis

scholarly journals Acceptability of Voluntary Counselling and Testing (VCT) Among Tuberculosis (TB) Patients in Ghana

2021 ◽  
Vol 9 (2) ◽  
pp. 118-128
Author(s):  
Ibrahim Ibn Saana
Keyword(s):  
Treatment Options ◽  
Rapid Test ◽  
Test Methods ◽  
Hiv Positive ◽  
Demographic Information ◽  
Tuberculosis Patients ◽  
Factors Associated ◽  
Logistic Regression Method ◽  
Rapid Test Methods ◽  
Voluntary Counselling And Testing

Patients should first be counselled and tested for HIV to benefit from available care and treatment options. The aim of this paper was to find out the level of acceptance of HIV testing among patients who visit the Chest Diseases Clinic of the Korle-Bu Teaching Hospital, Ghana. Information about all adult tuberculosis patients who attended the clinic between January and December 2019 in which patients’ socio-demographic information and tuberculosis treatment history were taken from the TB register, patients who showed initial willingness were referred to a VCT counsellor for HIV counselling before testing was done. Rapid test methods were used, and the results were disclosed. The logistic regression method was used to assess the factors associated with HIV co-infection, willingness, and acceptability. 250 tuberculosis (TB) patients who were among the total of 485 gave their consent and willingly participated in this study. Their median age was 30 years (range, 13–50+), and 56.8% of them were females. 29 patients had tested previously, including 29 HIV positive. 66.0% (165) were willing to be tested.

scholarly journals Fetal deaths in Brazil: a systematic review

2015 ◽  
Vol 49 (0) ◽  
Author(s):  
Fernanda Morena dos Santos Barbeiro ◽  
Sandra Costa Fonseca ◽  
Mariana Girão Tauffer ◽  
Mariana de Souza Santos Ferreira ◽  
Fagner Paulo da Silva ◽  
...  
Keyword(s):  
Systematic Review ◽  
Prenatal Care ◽  
Causes Of Death ◽  
Fetal Death ◽  
Data Extraction ◽  
Fetal Mortality ◽  
Death Certificates ◽  
Quality Of Data ◽  
Factors Associated ◽  
Inadequate Prenatal Care

OBJECTIVE To review the frequency of and factors associated with fetal death in the Brazilian scientific literature.METHODS A systematic review of Brazilian studies on fetal deaths published between 2003 and 2013 was conducted. In total, 27 studies were analyzed; of these, 4 studies addressed the quality of data, 12 were descriptive studies, and 11 studies evaluated the factors associated with fetal death. The databases searched were PubMed and Lilacs, and data extraction and synthesis were independently performed by two or more examiners.RESULTS The level of completeness of fetal death certificates was deficient, both in the completion of variables, particularly sociodemographic variables, and in defining the underlying causes of death. Fetal deaths have decreased in Brazil; however, inequalities persist. Analysis of the causes of death indicated maternal morbidities that could be prevented and treated. The main factors associated with fetal deaths were absent or inadequate prenatal care, low education level, maternal morbidity, and adverse reproductive history.CONCLUSIONS Prenatal care should prioritize women that are most vulnerable (considering their social environment or their reproductive history and morbidities) with the aim of decreasing the fetal mortality rate in Brazil. Adequate completion of death certificates and investment in the committees that investigate fetal and infant deaths are necessary.

scholarly journals Factors Associated with Pulmonary Tuberculosis Patients Who Received Anti-TB Treatment

2017 ◽  
Author(s):  
Tien Zubaidah ◽  
Ratna Setyaningrum ◽  
Muhamad Ratodi
Keyword(s):  
Socioeconomic Status ◽  
Pulmonary Tuberculosis ◽  
Education Level ◽  
Tuberculosis Patients ◽  
Factors Associated ◽  
Independent Variables ◽  
Tb Treatment ◽  
Gender And Education ◽  
Low Education ◽  
Male Subjects

Pulmonary tuberculosis is a chronic infectious disease that was closely related to the environment and human behavior. To overcome pulmonary tuberculosis, various factors associated with TB who received anti-TB treatment became very important. Therefore, we extend the Riskesdas data analysis To determine the various factors associated with Pulmonary TB patients received anti-TB treatment. Subject treated with anti-TB treatment became the dependent variable, while the independent variables consisted of subjects characteristics (age, gender, and education level), socioeconomic status and residential classification. Logistic regression was used to identify factors associated with the use of anti-tuberculosis. The result showed that male subjects with age of 35 until 44 years, low education, consider poor in economic and inhabited in the urban area more common in subjects with anti-TB treatment. Thus, characteristics of subjects (age, gender, and education level), socioeconomic status and residential classification are the factors of subjects treated with anti-tuberculosis in Indonesia

scholarly journals Socio-demographic Factors Associated with Treatment Initiation Delays among Tuberculosis Patients in Namibia

2019 ◽  
pp. 1-11
Author(s):  
Francis F. Chikuse ◽  
Loveness N. Dzikiti ◽  
Auxilia Chideme-Munodawafa ◽  
Talkmore Maruta ◽  
Greanious A. Mavondo ◽  
...  
Keyword(s):  
Health Care ◽  
Treatment Initiation ◽  
Demographic Factors ◽  
Hiv Care ◽  
Prolonged Treatment ◽  
Hiv Positive ◽  
Cross Sectional ◽  
Factors Associated ◽  
Tb Treatment ◽  
Socio Demographic Factors

Background: Delayed tuberculosis (TB) treatment increases the rate of spread of the bacilli in the community and mortality rates. Rapid diagnosis and early TB treatment initiation are crucial to successful outcomes and delays affect TB control programs. In Namibia, there is a paucity of data on the demographic factors affecting TB treatment initiation since GeneXpert MTB/RIF (Xpert) assay was introduced in 2017. Methods: This was a descriptive cross-sectional retrospective study conducted at Katutura Hospital TB clinic from 1st July 2018 to 31st March 2019. A total of seventy-two (72) participants comprising twenty-five (25) rifampicin resistant-TB (RR-TB) and forty-seven (47) non- RR-TB adult patients were enrolled using consecutive sampling. Patients’ medical records, Xpert results and a questionnaire were used to collect data. The data were analyzed using Stata statistical software version 12. Association between socio-demographic factors and treatment initiation delays were established using logistic regression analysis. Results: Staying with a TB patient (AOR=17.22, 95% CI: 2.29-129.773), employment status (AOR=1.23, 95% CI, 002-129), previous TB treatment (AOR=2.19, 95% CI: 0.076-0.86) and being HIV positive (AOR= 1.23, 95% CI: 0.0034-057) were the socio-demographic factors that were significantly associated with treatment initiation delays. Treatment initiation delay median time at Katutura Intermediate Hospital TB Clinic was 10 days (IQR: 1-32) and 3 days (IQR: 0-12) for RR-TB and non- RR-TB respectively. Conclusion: The prolonged treatment initiation delays among HIV positive RR-TB patients might be due to low adherence to HIV care interventions. Staying with a household TB patient and those who were previously treated for TB were also associated with treatment initiation delays. Poor health systems infrastructure and stigma could be the determinants of this delay in these groups. An integrated family-based approach to TB and HIV care involving health care workers can mitigate TB treatment delays post-diagnosis. Further studies should explore the factors associated with late initiation to second-line treatment from a community perspective. Lastly, there is a need to assess the cost-utility of bedaquiline and delamanid drugs roll-out in Namibian health care in comparison with the standard treatment.

scholarly journals Patient and health system factors associated with pretreatment loss to follow up among patients diagnosed with tuberculosis using Xpert® MTB/RIF testing in Uganda

2020 ◽  
Author(s):  
Stella Zawedde-Muyanja ◽  
Achilles Katamba ◽  
Adithya Cattamanchi ◽  
Barbara Castelnuovo ◽  
Yukari C Manabe
Keyword(s):  
Public Health ◽  
Health Facility ◽  
High Volume ◽  
Health Facilities ◽  
High Rate ◽  
Loss To Follow Up ◽  
Public Health Facilities ◽  
Factors Associated ◽  
Tb Treatment

Abstract Background: In 2018, Uganda started only 65% of persons with incident tuberculosis on treatment. Pretreatment loss to follow up is an important contributor to suboptimal treatment coverage. We aimed to describe the patient and health facility-level characteristics associated with pretreatment loss to follow up among patients diagnosed with pulmonary tuberculosis at public health facilities in Uganda. Methods: At ten public health facilities, laboratory register data was used to identify patients aged 15 years who had a positive Xpert®MTB/RIF test. Initiation on TB treatment was ascertained using the clinical register. Factors associated with not being initiated on TB treatment within two weeks of diagnosis were examined using a multilevel logistic regression model accounting for clustering by health facility. Results:From January to June 2018, 510 patients (61.2% male and 31.5% HIV co-infected) were diagnosed with tuberculosis. One hundred (19.6%) were not initiated on TB treatment within two weeks of diagnosis. Not having a phone number recorded in the clinic registers (aOR 7.93, 95%CI 3.93-13.05); being HIV-infected (aOR 1.83; 95% CI: 1.09-3.26) and receiving care from a high volume health facility performing more than 12 Xpert tests per day (aOR 4.37, 95%CI 1.69-11.29) and were significantly associated with pretreatment loss to follow up. Conclusion: In public health facilities in Uganda, we found a high rate of pretreatment loss to follow up especially among TBHIV co-infected patients diagnosed at high volume health facilities. Interventions to improve the efficiency of Xpert® MTB/RIF testing, including monitoring of the TB care cascade should be developed and implemented.

scholarly journals Seroprevalence of Aspergillus-Specific IgG Antibody among Mozambican Tuberculosis Patients

2021 ◽  
Vol 7 (8) ◽  
pp. 595
Author(s):  
Helmut J. F. Salzer ◽  
Isabel Massango ◽  
Nilesh Bhatt ◽  
Emelva Machonisse ◽  
Maja Reimann ◽  
...  
Keyword(s):  
Antibody Level ◽  
Hiv Positive ◽  
Igg Antibody ◽  
Tuberculosis Patients ◽  
Tb Treatment ◽  
Life Threatening ◽  
Specific Igg ◽  
Limited Health ◽  
Antibody Levels ◽  
Hiv Negative

Background: Chronic pulmonary aspergillosis (CPA) is a life-threatening sequel in patients with pulmonary tuberculosis (PTB). Aspergillus-specific IgG antibody is a useful diagnostic biomarker supporting CPA diagnosis, especially in countries with limited health recourses. Methods: We conducted a prospective pilot study to assess the seroprevalence of Aspergillus-specific IgG antibodies among 61 Mozambican tuberculosis patients before, during, and after the end of TB treatment. Aspergillus-specific IgG antibody levels were measured using the ImmunoCAP®. Results: In this study, 3 out of 21 HIV-negative PTB patients had a positive Aspergillus-specific IgG antibody level before, during, and after the end of TB treatment. Antibody levels were 41.1, 45.5, and 174 mg/L at end of treatment (EOT), respectively. Additionally, two HIV-negative PTB patients with negative Aspergillus-specific IgG antibody levels at baseline became seropositive at EOT (41.9 and 158 mg/L, respectively). Interestingly, none of the HIV-positive PTB patients (40/61) had a positive Aspergillus-specific IgG antibody level at any time, neither at baseline nor at EOT. Probable CPA was diagnosed in one HIV-negative patient (5%; 1/20). Conclusion: Seroprevalence of Aspergillus-specific IgG antibody may differ between HIV-negative and HIV-positive Mozambican PTB patients. Future studies evaluating post-tuberculosis lung disease should integrate CPA as a life-threatening sequel to PTB.

HIV risk factors among patients with tuberculosis — Botswana 1999

2002 ◽  
Vol 13 (5) ◽  
pp. 311-317 ◽  
Author(s):  
Elizabeth A Talbot ◽  
Thomas A Kenyon ◽  
Themba L Moeti ◽  
Gary Hsin ◽  
Laura Dooley ◽  
...  
Keyword(s):  
Hiv Positive ◽  
Sex Partners ◽  
Regular Partner ◽  
Hiv Status ◽  
Prevention Strategies ◽  
Prevalence Odds Ratio ◽  
Tuberculosis Patients ◽  
Factors Associated ◽  
Hiv Prevention Strategies ◽  
Hiv Negative

To identify factors associated with HIV in Botswana, a standardized questionnaire was administered to 135 tuberculosis patients with known HIV status. HIV-positive patients were more likely than HIV-negative patients to: be female (45% vs 26% (adjusted prevalence odds ratio (aPOR)=3.8, 95% confidence interval (CI)=1.1-12.7)); be 26-35 years old (50% vs 19% (aPOR=2.7, CI=0.7-10.7)); be unmarried (91% vs 71% (aPOR=13.3, CI=2.5-72.7)); have higher income (24% vs 10% (aPOR=8.2, CI=1.6-42.9)); report separation from spouse/partner for work (63% vs 52% (aPOR=1.8, CI=0.5-6.2)); have 2 sex partners other than their regular partner (82% vs 67% (aPOR=1.8, CI=0.5-7.5)); and state that they or their partner drank alcohol before sex (77% vs 55% (aPOR=6.8, CI=1.9-24.1)). Only 22% of respondents used condoms during all of their past 10 sexual encounters. These data provide information for HIV prevention strategies.

scholarly journals Factors Associated with Mortality among Patients on TB Treatment in the Southern Region of Zimbabwe, 2013

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Kudakwashe C. Takarinda ◽  
Charles Sandy ◽  
Nyasha Masuka ◽  
Patrick Hazangwe ◽  
Regis C. Choto ◽  
...  
Keyword(s):  
Mortality Rates ◽  
Hiv Positive ◽  
Adjusted Relative Risk ◽  
Cumulative Mortality ◽  
Retrospective Record Review ◽  
Factors Associated ◽  
Art Initiation ◽  
Tb Treatment ◽  
Immunodeficiency Virus ◽  
Record Review

Background. In 2013, the tuberculosis (TB) mortality rate was highest in southern Zimbabwe at 16%. We therefore sought to determine factors associated with mortality among registered TB patients in this region.Methodology. This was a retrospective record review of registered patients receiving anti-TB treatment in 2013.Results. Of 1,971 registered TB patients, 1,653 (84%) were new cases compared with 314 (16%) retreatment cases. There were 1,538 (78%) TB/human immunodeficiency virus (HIV) coinfected patients, of whom 1,399 (91%) were on antiretroviral therapy (ART) with median pre-ART CD4 count of 133 cells/uL (IQR, 46–282). Overall, 428 (22%) TB patients died. Factors associated with increased mortality included being ≥65 years old [adjusted relative risk (ARR) = 2.48 (95% CI 1.35–4.55)], a retreatment TB case [ARR = 1.34 (95% CI, 1.10–1.63)], and being HIV-positive [ARR = 1.87 (95% CI, 1.44–2.42)] whilst ART initiation was protective [ARR = 0.25 (95% CI, 0.22–0.29)]. Cumulative mortality rates were 10%, 14%, and 21% at one, two, and six months, respectively, after starting TB treatment.Conclusion. There was high mortality especially in the first two months of anti-TB treatment, with risk factors being recurrent TB and being HIV-infected, despite a high uptake of ART.

Sign in / Sign up

Export Citation Format

Share Document