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Associated factors with deaths among pulmonary tuberculosis patients: a case-control study with secondary data
  1. Elisabeth Carmen Duarte1,
  2. Ana Luiza Bierrenbach2,
  3. Jarbas Barbosa da Silva Junior, Jr3,
  4. Pedro Luiz Tauil1,
  5. Eliane de Fátima Duarte4
  1. 1 Brasilia University - Faculdade de Medicina - Area de Medicina Social, Brazil;
  2. 2 World Health Organization – Geneva, Switzerland;
  3. 3 Pan-American Health Organization – Washington – DC, United States;
  4. 4 McGill University, Brazil
  1. E-mail: eduarte{at}unb.br

Abstract

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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