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Factores de riesgo para muerte en pacientes con TB, no infectados con VIH, en Tailandia, 2004 – 2006
Author(s) -
Amnuaiphon Waraya,
Anuwatthakate Amornrat,
Nuyongphak Prungsri,
Sinthuwatanawibool Chalinthorn,
Rujiwongsakorn Sadudee,
Nakara Prapa,
Komsakorn Sitijate,
Wattanaamornkiet Wanpen,
Moolphate Saiyud,
Chiengsorn Navarat,
Kaewsaard Samroui,
Nateniyom Sriprapa,
Varma Jay K.
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.1365-3156.2009.02376.x
Subject(s) - medicine , tuberculosis , relative risk , confidence interval , cause of death , epidemiology , demography , risk factor , pediatrics , disease , pathology , sociology
Summary Objectives In countries with both TB and human immunodeficiency virus (HIV) epidemics, HIV is known to be the most powerful risk factor for death during tuberculosis (TB) treatment. Few recent studies have evaluated risk factors for death among HIV‐uninfected TB patients in these countries. We analysed data from a multi‐province demonstration project in Thailand to answer this question. Method We prospectively collected data from HIV‐uninfected TB patients treated for TB in four provinces and the national infectious diseases hospital in Thailand from 2004–2006. Standard WHO definitions were used to classify treatment outcomes. We used log‐binomial multivariate regression to calculate adjusted relative risk (aRR) and 95% confidence intervals (CI) for factors associated with death. Results Of 5318 cases, 441 (8%) died during TB treatment. The mean age was 47 years (range 8 months–97 years). Multidrug‐resistant (MDR)‐TB was diagnosed in 62 (1%). In multivariate analysis, patients older than 44 years were significantly more likely to die than patients aged 15–44 years [age 45–64, aRR 2.9 (CI 2.2–3.8)] [age > 64 years, aRR 5.0 (CI 3.9–6.6)]. Other independent risk factors for death included Thai nationality [aRR 3.9 (CI 1.6–9.5)], MDR‐TB [aRR 2.8 (CI 1.7–4.8)], not being married [aRR 1.4 (CI 1.2–1.7)], and living in Chiang Rai province [aRR 2.7 (CI 1.7–4.4)]. Conclusions The death rate was high among HIV‐uninfected TB patients in Thailand. Efforts to improve TB diagnosis and treatment in the elderly and to improve MDR‐TB treatment may help reduce mortality.