High Mortality Rates Among Individuals Misdiagnosed With Tuberculosis: A Matched Retrospective Cohort Study of Individuals Diagnosed With Tuberculosis in Brazil

J Infect Dis. 2025 Jun 2;231(5):1267-1270. doi: 10.1093/infdis/jiae531.

Abstract

We conducted a matched retrospective cohort study comparing mortality among individuals receiving a false-positive tuberculosis (TB) diagnosis (n = 3701) to individuals correctly diagnosed with TB (n = 8595) in Brazil from 2007 to 2016. Over an average 5.4-year follow-up period, we estimated a mortality rate ratio of 1.95 (95% confidence interval, 1.80-2.11) for individuals incorrectly diagnosed with TB compared to controls. The leading causes of death among the misdiagnosed were malignant neoplasms (40.9%) and respiratory system disorders (15.9%), conditions with symptoms similar to TB. Our findings highlight the need for improved follow-up care after identification of false-positive cases to increase survival for this high-risk population.

Keywords: Brazil; electronic medical records; misdiagnosis; survival analysis; tuberculosis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brazil / epidemiology
  • Child
  • Child, Preschool
  • Diagnostic Errors* / mortality
  • Diagnostic Errors* / statistics & numerical data
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tuberculosis* / diagnosis
  • Tuberculosis* / mortality
  • Young Adult