Mortality among tuberculosis patients under DOTS programme: a historical cohort study

BMC Public Health. 2016 Aug 25;16(1):883. doi: 10.1186/s12889-016-3557-0.

Abstract

Background: In high human immunodeficiency virus (HIV) prevalence population, tuberculosis (TB) is the leading cause of morbidity and mortality. HIV is driving the TB epidemic in many countries, especially those in sub-Saharan Africa. We assessed the survival time and predictors of mortality among tuberculosis patients under directly observed treatment, short course (DOTS) strategy in Dessie Referral Hospital tuberculosis clinic, Northeast Ethiopia.

Method: A historical cohort design was utilized to assess survival time and determinants of mortality. A total of 1260 records of patients who started ant-tuberculosis treatment from January 2006 up to December 2010 were analyzed. Survival curves were estimated using Kaplan-Meier and were compared using the Log-rank test. The Cox proportional hazard model was used to assess the relationship between baseline variables and mortality.

Results: Out of the 1260 registered patients, 117 (9.3 %) died over the entire follow-up period. Among those died, 113 (18 %) were HIV positive and 4 (0.6 %) were HIV negative. The 1260 patients contributed a cumulative total of 634.25 person‑years observation.

Conclusion: The mortality of HIV positive tuberculosis patients was higher than those of HIV negative patients and the use of cotrimoxazole preventive therapy increased the survival time of patients.

Keywords: Dessie Referral Hospital; HIV; Mortality; Survival; Tuberculosis.

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Cohort Studies
  • Directly Observed Therapy*
  • Ethiopia / epidemiology
  • Female
  • HIV Seropositivity / complications*
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Referral and Consultation
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use
  • Tuberculosis / mortality*
  • Tuberculosis / prevention & control
  • Tuberculosis / virology
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Trimethoprim, Sulfamethoxazole Drug Combination