SETTING AND METHODS: In Orel, high tuberculosis (TB) case fatality rates have persisted despite successful implementation of the World Health Organization (WHO) global TB control strategy. We conducted a case control study to identify risk factors for mortality among Orel TB patients reported from October 1999 through June 2001. Cases were patients who died within 8 months of treatment initiation. We analyzed data abstracted from medical records using conditional logistic regression. RESULTS: Over the 21-month period, 63/1069 (5.9%) TB patients overall and 45/521 (8.6%) sputum smear-positive patients died during treatment. Compared to 192 controls, independent risk factors for death for both smear-positive and smear-negative patients included unemployment (adjusted odds ratio [AOR] 4.9, 95% confidence interval [CI] 1.9-12.9), homelessness (AOR 9.5, 95% CI 1.3-70.9), congestive heart failure (AOR 5.4, 95% CI 1.9-15.9), chronic lung disease (AOR 2.4, 95% CI 1.1-5.4), cancer (AOR 7.2, 95% CI 1.2-45.0), bilateral disease on chest X-ray (AOR 6.3, 95% CI 2.3-17.1), and hyperbilirubinemia (AOR 5.2, 95% CI 1.1-25.3). Among deaths, the median time from treatment initiation to death was 35 days. CONCLUSIONS: The diagnosis and treatment of TB in suspects with the observed comorbidities and risk factors should be aggressively pursued. The association of unemployment and homelessness with mortality suggests a contribution of poverty to death during TB treatment.
SETTING AND METHODS: In Orel, high tuberculosis (TB) case fatality rates have persisted despite successful implementation of the World Health Organization (WHO) global TB control strategy. We conducted a case control study to identify risk factors for mortality among Orel TB patients reported from October 1999 through June 2001. Cases were patients who died within 8 months of treatment initiation. We analyzed data abstracted from medical records using conditional logistic regression. RESULTS: Over the 21-month period, 63/1069 (5.9%) TB patients overall and 45/521 (8.6%) sputum smear-positive patients died during treatment. Compared to 192 controls, independent risk factors for death for both smear-positive and smear-negative patients included unemployment (adjusted odds ratio [AOR] 4.9, 95% confidence interval [CI] 1.9-12.9), homelessness (AOR 9.5, 95% CI 1.3-70.9), congestive heart failure (AOR 5.4, 95% CI 1.9-15.9), chronic lung disease (AOR 2.4, 95% CI 1.1-5.4), cancer (AOR 7.2, 95% CI 1.2-45.0), bilateral disease on chest X-ray (AOR 6.3, 95% CI 2.3-17.1), and hyperbilirubinemia (AOR 5.2, 95% CI 1.1-25.3). Among deaths, the median time from treatment initiation to death was 35 days. CONCLUSIONS: The diagnosis and treatment of TB in suspects with the observed comorbidities and risk factors should be aggressively pursued. The association of unemployment and homelessness with mortality suggests a contribution of poverty to death during TB treatment.
Authors: M F Fleming; E Krupitsky; M Tsoy; E Zvartau; N Brazhenko; W Jakubowiak; M E McCaul Journal: Int J Tuberc Lung Dis Date: 2006-05 Impact factor: 2.373
Authors: Denise R Silva; Diego M Menegotto; Luis F Schulz; Marcelo B Gazzana; Paulo Tr Dalcin Journal: BMC Infect Dis Date: 2010-03-07 Impact factor: 3.090
Authors: Trini A Mathew; Alan L Shields; Aizhan Imasheva; Sonya S Shin; Sergey P Mishustin; Gennady G Peremitin; Aivar K Strelis; Galina V Yanova; Shelly F Greenfield; Jennifer J Furin Journal: Cult Med Psychiatry Date: 2009-12
Authors: Trini A Mathew; Sergey A Yanov; Rais Mazitov; Sergey P Mishustin; Aivar K Strelis; Galina V Yanova; Vera T Golubchikova; Dmitry V Taran; Alex Golubkov; Alan L Shields; Shelly F Greenfield; Sonya S Shin Journal: Eur J Public Health Date: 2008-12-26 Impact factor: 3.367