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Risk factors for mortality in TB patients: a 10-year electronic record review in a South African province

BACKGROUND: Since 1990, reduction of tuberculosis (TB) mortality has been lower in South Africa than in other high-burden countries in Africa. This research investigated the influence of routinely captured demographic and clinical or programme variables on death in TB patients in the Free State Prov...

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Autores principales: Heunis, J Christo, Kigozi, N Gladys, Chikobvu, Perpetual, Botha, Sonja, van Rensburg, HCJ Dingie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5217308/
https://www.ncbi.nlm.nih.gov/pubmed/28061839
http://dx.doi.org/10.1186/s12889-016-3972-2
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author Heunis, J Christo
Kigozi, N Gladys
Chikobvu, Perpetual
Botha, Sonja
van Rensburg, HCJ Dingie
author_facet Heunis, J Christo
Kigozi, N Gladys
Chikobvu, Perpetual
Botha, Sonja
van Rensburg, HCJ Dingie
author_sort Heunis, J Christo
collection PubMed
description BACKGROUND: Since 1990, reduction of tuberculosis (TB) mortality has been lower in South Africa than in other high-burden countries in Africa. This research investigated the influence of routinely captured demographic and clinical or programme variables on death in TB patients in the Free State Province. METHODS: A retrospective review of case information captured in the Electronic TB register (ETR.net) over the years 2003 to 2012 was conducted. Extracted data were subjected to descriptive and logistic regression analyses. The outcome variable was defined as all registered TB cases with ‘died’ as the recorded outcome. The variables associated with increased or decreased odds of dying in TB patients were established. The univariate and adjusted odds ratios (OR and AOR) together with their corresponding 95% confidence intervals (CI) were estimated, taking the clustering effect of the districts into account. RESULTS: Of the 190,472 TB cases included in the analysis, 30,991 (16.3%) had ‘died’ as the recorded treatment outcome. The proportion of TB patients that died increased from 15.1% in 2003 to 17.8% in 2009, before declining to 15.4% in 2012. The odds of dying was incrementally higher in the older age groups: 8–17 years (AOR: 2.0; CI: 1.5–2.7), 18–49 years (AOR: 5.8; CI: 4.0–8.4), 50–64 years (AOR: 7.7; CI: 4.6–12.7), and ≥65 years (AOR: 14.4; CI: 10.3–20.2). Other factors associated with increased odds of mortality included: HIV co-infection (males – AOR: 2.4; CI: 2.1–2.8; females – AOR: 1.9; CI: 1.7–2.1) or unknown HIV status (males – AOR: 2.8; CI: 2.5–3.1; females – AOR: 2.4; CI: 2.2–2.6), having a negative (AOR: 1.4; CI: 1.3–1.6) or a missing (AOR: 2.1; CI: 1.4–3.2) pre-treatment sputum smear result, and being a retreatment case (AOR: 1.3; CI: 1.2–1.4). CONCLUSIONS: Although mortality in TB patients in the Free State has been falling since 2009, it remained high at more than 15% in 2012. Appropriately targeted treatment and care for the identified high-risk groups could be considered.
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spelling pubmed-52173082017-01-09 Risk factors for mortality in TB patients: a 10-year electronic record review in a South African province Heunis, J Christo Kigozi, N Gladys Chikobvu, Perpetual Botha, Sonja van Rensburg, HCJ Dingie BMC Public Health Research Article BACKGROUND: Since 1990, reduction of tuberculosis (TB) mortality has been lower in South Africa than in other high-burden countries in Africa. This research investigated the influence of routinely captured demographic and clinical or programme variables on death in TB patients in the Free State Province. METHODS: A retrospective review of case information captured in the Electronic TB register (ETR.net) over the years 2003 to 2012 was conducted. Extracted data were subjected to descriptive and logistic regression analyses. The outcome variable was defined as all registered TB cases with ‘died’ as the recorded outcome. The variables associated with increased or decreased odds of dying in TB patients were established. The univariate and adjusted odds ratios (OR and AOR) together with their corresponding 95% confidence intervals (CI) were estimated, taking the clustering effect of the districts into account. RESULTS: Of the 190,472 TB cases included in the analysis, 30,991 (16.3%) had ‘died’ as the recorded treatment outcome. The proportion of TB patients that died increased from 15.1% in 2003 to 17.8% in 2009, before declining to 15.4% in 2012. The odds of dying was incrementally higher in the older age groups: 8–17 years (AOR: 2.0; CI: 1.5–2.7), 18–49 years (AOR: 5.8; CI: 4.0–8.4), 50–64 years (AOR: 7.7; CI: 4.6–12.7), and ≥65 years (AOR: 14.4; CI: 10.3–20.2). Other factors associated with increased odds of mortality included: HIV co-infection (males – AOR: 2.4; CI: 2.1–2.8; females – AOR: 1.9; CI: 1.7–2.1) or unknown HIV status (males – AOR: 2.8; CI: 2.5–3.1; females – AOR: 2.4; CI: 2.2–2.6), having a negative (AOR: 1.4; CI: 1.3–1.6) or a missing (AOR: 2.1; CI: 1.4–3.2) pre-treatment sputum smear result, and being a retreatment case (AOR: 1.3; CI: 1.2–1.4). CONCLUSIONS: Although mortality in TB patients in the Free State has been falling since 2009, it remained high at more than 15% in 2012. Appropriately targeted treatment and care for the identified high-risk groups could be considered. BioMed Central 2017-01-06 /pmc/articles/PMC5217308/ /pubmed/28061839 http://dx.doi.org/10.1186/s12889-016-3972-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Heunis, J Christo
Kigozi, N Gladys
Chikobvu, Perpetual
Botha, Sonja
van Rensburg, HCJ Dingie
Risk factors for mortality in TB patients: a 10-year electronic record review in a South African province
title Risk factors for mortality in TB patients: a 10-year electronic record review in a South African province
title_full Risk factors for mortality in TB patients: a 10-year electronic record review in a South African province
title_fullStr Risk factors for mortality in TB patients: a 10-year electronic record review in a South African province
title_full_unstemmed Risk factors for mortality in TB patients: a 10-year electronic record review in a South African province
title_short Risk factors for mortality in TB patients: a 10-year electronic record review in a South African province
title_sort risk factors for mortality in tb patients: a 10-year electronic record review in a south african province
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5217308/
https://www.ncbi.nlm.nih.gov/pubmed/28061839
http://dx.doi.org/10.1186/s12889-016-3972-2
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