Characteristics of tuberculosis-related deaths and risk factors: a retrospective cohort study in Samsun province of Turkey

ABSTRACT

Objectives

Tuberculosis (TB) remains one of the top ten leading causes of death worldwide despite effective therapy. The present study aims to examine the characteristics of TB-related deaths in Samsun Province and to determine the risk factors.

Methods

In this retrospective registry-based cohort study, the medical records of patients registered with Samsun Tuberculosis Control Dispensary between 1 January 2018 and 31 December 2019 were retrospectively reviewed. The Cox proportional-hazards model was used to determine the factors associated with the risk of death in patients with TB.

Results

The treatment outcomes of a total of 382 patients were reviewed. It was found that the treatment was successful in 346 patients (90.6%), and 31 patients (8.1%) died before or during TB therapy. The median survival time of patients who died during the therapy was 1.86 months (95% CI = 0.07–5.17 months), and more than 50% (13/25) of the deaths occurred in the first two months of the treatment. Age above 70 years (HR 15.06 (3.33–67.95)), male gender (HR 2.74 (1.02–7.33)), pulmonary TB (HR 2.92 (1.002–8.52)), multidrug-resistant (MDR) tuberculosis (HR 1.69 (1.22–12.75)), and a delay in the treatment of more than ten days (HR 2.71 (1.22–6.04)) were identified as risk factors associated with mortality in TB patients (p < 0.05).

Conclusion

The majority of deaths in our cohort occurred within the first two months after starting the treatment. Advanced age, male sex, a new diagnosis of TB, pulmonary TB, MDR-TB, and a treatment delay of more than ten days after diagnosis increased the risk for mortality during antituberculosis treatment.

KEYWORDS:

• Tuberculosis control
• mortality
• risk factor
• health policy

Disclosure of financial/other conflicts of interest

The authors have no relevant conflicts of interest to disclose. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Authors contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by SO and DO. The first draft of the manuscript was written by DO and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Consent for publication

All participants have agreed for their responses to be anonymized and presented for publication purposes.

Ethics approval

The study was approved by the Clinical Research Ethics Committee of Ondokuz Mayıs University.

Institutional Review Board protocol approval number: 2021/158

Institutional Review Board protocol approval number date: 18.3.2021

Additional information

Funding

The authors have no funding to report.