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Int J Tuberc Lung Dis. 2011 Apr;15(4):465-70. doi: 10.5588/ijtld.10.0259.

Patients diagnosed with tuberculosis at death or who died during therapy: association with the human immunodeficiency virus.

Author information

  • 1Division of Tuberculosis Elimination, US Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. smarks@cdc.gov

Abstract

OBJECTIVES:

To describe trends and risk factors for tuberculosis (TB) mortality.

DESIGN:

We calculated trends, identified patient characteristics associated with TB diagnosis at death or death during TB treatment, and described diagnostic procedures using the United States National TB Surveillance System for 1997-2005.

RESULTS:

Human immunodeficiency virus (HIV) infected TB patients had an adjusted odds ratio (aOR) of 4-11 for TB diagnosis at death (foreign-born non-Whites, aOR = 11) and of 3-19 for death during TB treatment vs. non-HIV-infected patients. Odds increased by age. Hispanic males had an aOR of 2 for TB diagnosis at death compared with female non-Hispanics. Multidrug-resistant TB (MDR-TB) patients had a three times greater aOR of death during treatment than non-MDR patients. American Indians, Black females, residents in long-term care facilities, US-born patients, and non-HIV-infected homeless persons aged 25-44 years each had an aOR of 2 for mortality during treatment; 86% of pulmonary patients diagnosed at death had a chest radiograph, but 34% had no sputum smear or culture reported.

CONCLUSION:

During 1997-2005, controlling for age, HIV remained the characteristic with the greatest aOR for TB diagnosis at death or death during TB therapy. Race/ethnicity, country of birth and homelessness further increased the adjusted odds of death. Results show possible missed opportunities for TB diagnosis prior to death.

PMID:
21396204
[PubMed - indexed for MEDLINE]
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