Cargando…

The timing of death in patients with tuberculosis who die during anti-tuberculosis treatment in Andhra Pradesh, South India

BACKGROUND: India has 2.0 million estimated tuberculosis (TB) cases per annum with an estimated 280,000 TB-related deaths per year. Understanding when in the course of TB treatment patients die is important for determining the type of intervention to be offered and crucially when this intervention s...

Descripción completa

Detalles Bibliográficos
Autores principales: Jonnalagada, Subbanna, Harries, Anthony D, Zachariah, Rony, Satyanarayana, Srinath, Tetali, Shailaja, Keshav Chander, G, Rao, Srinivas, Rao, Ranganadha, Peri, Sundaresh, Anchala, Raghupathy, Kannuri, Nanda K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3254139/
https://www.ncbi.nlm.nih.gov/pubmed/22166132
http://dx.doi.org/10.1186/1471-2458-11-921
_version_ 1782220806064963584
author Jonnalagada, Subbanna
Harries, Anthony D
Zachariah, Rony
Satyanarayana, Srinath
Tetali, Shailaja
Keshav Chander, G
Rao, Srinivas
Rao, Ranganadha
Peri, Sundaresh
Anchala, Raghupathy
Kannuri, Nanda K
author_facet Jonnalagada, Subbanna
Harries, Anthony D
Zachariah, Rony
Satyanarayana, Srinath
Tetali, Shailaja
Keshav Chander, G
Rao, Srinivas
Rao, Ranganadha
Peri, Sundaresh
Anchala, Raghupathy
Kannuri, Nanda K
author_sort Jonnalagada, Subbanna
collection PubMed
description BACKGROUND: India has 2.0 million estimated tuberculosis (TB) cases per annum with an estimated 280,000 TB-related deaths per year. Understanding when in the course of TB treatment patients die is important for determining the type of intervention to be offered and crucially when this intervention should be given. The objectives of the current study were to determine in a large cohort of TB patients in India:- i) treatment outcomes including the number who died while on treatment, ii) the month of death and iii) characteristics associated with "early" death, occurring in the initial 8 weeks of treatment. METHODS: This was a retrospective study in 16 selected Designated Microscopy Centres (DMCs) in Hyderabad, Krishna and Adilabad districts of Andhra Pradesh, South India. A review was performed of treatment cards and medical records of all TB patients (adults and children) registered and placed on standardized anti-tuberculosis treatment from January 2005 to September 2009. RESULTS: There were 8,240 TB patients (5183 males) of whom 492 (6%) were known to have died during treatment. Case-fatality was higher in those previously treated (12%) and lower in those with extra-pulmonary TB (2%). There was an even distribution of deaths during anti-tuberculosis treatment, with 28% of all patients dying in the first 8 weeks of treatment. Increasing age and new as compared to recurrent TB disease were significantly associated with "early death". CONCLUSION: In this large cohort of TB patients, deaths occurred with an even frequency throughout anti-TB treatment. Reasons may relate to i) the treatment of the disease itself, raising concerns about drug adherence, quality of anti-tuberculosis drugs or the presence of undetected drug resistance and ii) co-morbidities, such as HIV/AIDS and diabetes mellitus, which are known to influence mortality. More research in this area from prospective and retrospective studies is needed.
format Online
Article
Text
id pubmed-3254139
institution National Center for Biotechnology Information
language English
publishDate 2011
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-32541392012-01-11 The timing of death in patients with tuberculosis who die during anti-tuberculosis treatment in Andhra Pradesh, South India Jonnalagada, Subbanna Harries, Anthony D Zachariah, Rony Satyanarayana, Srinath Tetali, Shailaja Keshav Chander, G Rao, Srinivas Rao, Ranganadha Peri, Sundaresh Anchala, Raghupathy Kannuri, Nanda K BMC Public Health Research Article BACKGROUND: India has 2.0 million estimated tuberculosis (TB) cases per annum with an estimated 280,000 TB-related deaths per year. Understanding when in the course of TB treatment patients die is important for determining the type of intervention to be offered and crucially when this intervention should be given. The objectives of the current study were to determine in a large cohort of TB patients in India:- i) treatment outcomes including the number who died while on treatment, ii) the month of death and iii) characteristics associated with "early" death, occurring in the initial 8 weeks of treatment. METHODS: This was a retrospective study in 16 selected Designated Microscopy Centres (DMCs) in Hyderabad, Krishna and Adilabad districts of Andhra Pradesh, South India. A review was performed of treatment cards and medical records of all TB patients (adults and children) registered and placed on standardized anti-tuberculosis treatment from January 2005 to September 2009. RESULTS: There were 8,240 TB patients (5183 males) of whom 492 (6%) were known to have died during treatment. Case-fatality was higher in those previously treated (12%) and lower in those with extra-pulmonary TB (2%). There was an even distribution of deaths during anti-tuberculosis treatment, with 28% of all patients dying in the first 8 weeks of treatment. Increasing age and new as compared to recurrent TB disease were significantly associated with "early death". CONCLUSION: In this large cohort of TB patients, deaths occurred with an even frequency throughout anti-TB treatment. Reasons may relate to i) the treatment of the disease itself, raising concerns about drug adherence, quality of anti-tuberculosis drugs or the presence of undetected drug resistance and ii) co-morbidities, such as HIV/AIDS and diabetes mellitus, which are known to influence mortality. More research in this area from prospective and retrospective studies is needed. BioMed Central 2011-12-13 /pmc/articles/PMC3254139/ /pubmed/22166132 http://dx.doi.org/10.1186/1471-2458-11-921 Text en Copyright ©2011 Jonnalagada et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
spellingShingle Research Article
Jonnalagada, Subbanna
Harries, Anthony D
Zachariah, Rony
Satyanarayana, Srinath
Tetali, Shailaja
Keshav Chander, G
Rao, Srinivas
Rao, Ranganadha
Peri, Sundaresh
Anchala, Raghupathy
Kannuri, Nanda K
The timing of death in patients with tuberculosis who die during anti-tuberculosis treatment in Andhra Pradesh, South India
title The timing of death in patients with tuberculosis who die during anti-tuberculosis treatment in Andhra Pradesh, South India
title_full The timing of death in patients with tuberculosis who die during anti-tuberculosis treatment in Andhra Pradesh, South India
title_fullStr The timing of death in patients with tuberculosis who die during anti-tuberculosis treatment in Andhra Pradesh, South India
title_full_unstemmed The timing of death in patients with tuberculosis who die during anti-tuberculosis treatment in Andhra Pradesh, South India
title_short The timing of death in patients with tuberculosis who die during anti-tuberculosis treatment in Andhra Pradesh, South India
title_sort timing of death in patients with tuberculosis who die during anti-tuberculosis treatment in andhra pradesh, south india
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3254139/
https://www.ncbi.nlm.nih.gov/pubmed/22166132
http://dx.doi.org/10.1186/1471-2458-11-921
work_keys_str_mv AT jonnalagadasubbanna thetimingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT harriesanthonyd thetimingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT zachariahrony thetimingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT satyanarayanasrinath thetimingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT tetalishailaja thetimingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT keshavchanderg thetimingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT raosrinivas thetimingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT raoranganadha thetimingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT perisundaresh thetimingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT anchalaraghupathy thetimingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT kannurinandak thetimingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT jonnalagadasubbanna timingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT harriesanthonyd timingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT zachariahrony timingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT satyanarayanasrinath timingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT tetalishailaja timingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT keshavchanderg timingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT raosrinivas timingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT raoranganadha timingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT perisundaresh timingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT anchalaraghupathy timingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia
AT kannurinandak timingofdeathinpatientswithtuberculosiswhodieduringantituberculosistreatmentinandhrapradeshsouthindia