K Dale1, E Tay2, P Trevan1, J T Denholm3. 1. Victorian Tuberculosis Program, Melbourne, Victoria, Australia. 2. Department of Health and Human Services, Melbourne, Victoria, Australia. 3. Victorian Tuberculosis Program, Melbourne, Victoria, Australia; Department of Microbiology and Immunology, University of Melbourne, Melbourne, Victoria, Australia.
Abstract
SETTING: The state of Victoria, Australia, is an industrialised setting with low tuberculosis (TB) incidence, universal health care and high levels of migration. OBJECTIVE: To assess case fatality rates (CFRs) and factors associated with death in a cohort of TB cases notified between 2002 and 2013. DESIGN: Retrospective cohort study. Cases who died untreated or during treatment were reviewed to determine whether TB was a primary cause of, contributed to or was unrelated to death. Descriptive and multivariate analyses were used to compare demographic, clinical and pathological characteristics. RESULTS: Of 3956 cases, 198 (5.0%) died of any cause. TB was the primary cause of death in 99 cases (50.3%) and contributed to death in a further 34 cases, giving a TB-related CFR of 3.4%. In multivariate analysis, TB-related mortality reduced over time, and was positively associated with male sex, older age, history of substance use and disseminated or meningeal TB. Factors associated with survival included having a history of past travel to or residence in a high TB risk country, lymph node TB or extra-pulmonary TB manifestations, excluding meningeal, genitourinary, pleural and lymphnode TB. CONCLUSIONS: TB CFRs in this setting are among the lowest reported globally. TB mortality steadily decreased from 2002 to 2013.
SETTING: The state of Victoria, Australia, is an industrialised setting with low tuberculosis (TB) incidence, universal health care and high levels of migration. OBJECTIVE: To assess case fatality rates (CFRs) and factors associated with death in a cohort of TB cases notified between 2002 and 2013. DESIGN: Retrospective cohort study. Cases who died untreated or during treatment were reviewed to determine whether TB was a primary cause of, contributed to or was unrelated to death. Descriptive and multivariate analyses were used to compare demographic, clinical and pathological characteristics. RESULTS: Of 3956 cases, 198 (5.0%) died of any cause. TB was the primary cause of death in 99 cases (50.3%) and contributed to death in a further 34 cases, giving a TB-related CFR of 3.4%. In multivariate analysis, TB-related mortality reduced over time, and was positively associated with male sex, older age, history of substance use and disseminated or meningeal TB. Factors associated with survival included having a history of past travel to or residence in a high TB risk country, lymph node TB or extra-pulmonary TB manifestations, excluding meningeal, genitourinary, pleural and lymphnode TB. CONCLUSIONS: TB CFRs in this setting are among the lowest reported globally. TB mortality steadily decreased from 2002 to 2013.
Authors: Beau Z Carr; Esther M Briganti; Joseph Musemburi; Grant A Jenkin; Justin T Denholm Journal: BMC Infect Dis Date: 2022-02-02 Impact factor: 3.090