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El alto riesgo de mortalidad entre individuos que se asume son negativos para TB puede predecirse utilizando un test sencillo
Author(s) -
Rabna Paulo,
Andersen Andreas,
Wejse Christian,
Oliveira Ines,
Gomes Victor Francisco,
Haaland Maya Bonde,
Aaby Peter,
EugenOlsen Jesper
Publication year - 2009
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2009.02328.x
Subject(s) - supar , medicine , proportional hazards model , mortality rate , population , linear regression , prospective cohort study , cohort , survival analysis , demography , gastroenterology , urokinase receptor , urokinase , statistics , mathematics , sociology , environmental health
Summary Objectives To determine mortality among assumed TB negative (aTBneg) individuals in Guinea‐Bissau and to investigate whether plasma levels of soluble urokinase receptor (suPAR) can be used to determine post‐consultation mortality risk. Methods This prospective West‐African cohort study included 1007 aTBneg individuals who were enrolled from 2004 to 2006; 4983 age‐matched controls were followed for comparison. Plasma suPAR levels were measured using the suPARnostic ® ELISA. Survival was analysed using Cox regression, ROC curves and Kaplan–Meier analysis. Results After 3 months of follow‐up, mortality was 21 per 100 person‐year‐observation (PYO) among aTBneg individuals and three per 100 PYO among the control population [mortality rate ratio (MRR) = 6.92 (95% CI 4.48–10.7)]. SuPAR values ranged between 0.9 and 45 ng/ml in aTBneg individuals. A log‐linear relationship was found between suPAR levels <15 ng/ml and mortality. In the log‐linear range, a 1 ng/ml increase was associated with a 46% increase in the mortality rate: MRR = 1.46 (95% CI 1.34–1.59). The area under the ROC curves was 0.88 for HIV‐positive individuals and 0.79 for HIV‐negative individuals. Conclusions Our study showed a high mortality rate among aTBneg individuals and demonstrated that suPAR measurements can provide prognostic information on mortality among individuals without disease diagnosis. Measuring suPAR is a technically simple method for determining mortality risk in individuals that are assumed to be TB‐negative.