Objective: To study factors associated with death of incident cases of pulmonary tuberculosis (PT) during treatment.
Design: a case-control including all new cases of PT reported between 2000 and 2004; cases were patients who died of any cause and controls were those cured after the initial PT treatment. Data analyses included unconditional multiple hierarchical logistic regression.
Results: A total of 313,502 new cases of tuberculosis were reported between 2000 and 2004; 224,355 (71.6%) were cured after an initial treatment and 20,721 (6.6%) died during the surveillance follow-up. Over 82% of all cases were diagnosed with pulmonary tuberculosis (PT). After controlling for significant variables, the factors associated with a higher risk of death included gender (males: OR=1.4; p<0.001), age (< 5 years of age: OR=1.90; p<0.001, 30-59 years: OR=2.78; p<0.001 and over 60 years: OR=10.92; p<0.001), positive HIV serology (OR=10.59; p<0.001), alcoholism (OR=1.49; p<0.001), mental disorder (OR=1.80; p<0.001) and presence of additional lung pathology on chest X-ray (OR=2.22; p<0.001). Protective variables included education (highest level: OR=0.67; p<0.001).
Conclusions: Preventive interventions should target the most vulnerable patients, in particular the very young and the elderly, those HIV infected, and presenting a mental disorder or additional lung pathology.
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