Format

Send to

Choose Destination
See comment in PubMed Commons below
Int J Tuberc Lung Dis. 2012 Sep;16(9):1199-204. doi: 10.5588/ijtld.11.0613.

Mortality among tuberculosis patients in the Democratic Republic of Congo.

Author information

1
Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA. cashene@email.unc.edu

Abstract

SETTING:

Kinshasa, Democratic Republic of Congo.

OBJECTIVE:

To identify programmatic interventions for improved survival in patients receiving treatment for tuberculosis (TB) at primary care clinics.

DESIGN:

Retrospective cohort of adult patients initiating anti-tuberculosis treatment between January 2006 and May 2007.

RESULTS:

Among 5685 patients, 390 deaths occurred during anti-tuberculosis treatment, of which half (52%) did so during the first 2 months. Patients with smear-negative pulmonary TB were at greater risk of death in the first 2 months of treatment (human immunodeficiency virus [HIV] positive HR 1.49, 95%CI 0.89-2.49; HIV-negative HR 1.77 95%CI 1.06-2.95), but not thereafter. Patients with extra-pulmonary TB were at increased risk of death in the first 2 months of anti-tuberculosis treatment if they were non-HIV-infected (HR 2.42, 95%CI 1.52-3.85), and were half as likely to die during the remainder of treatment (HIV-positive HR 0.46, 95%CI 0.22-0.97; HIV-negative HR 0.47, 95%CI 0.23-0.94). Antiretroviral therapy (ART) reduced the risk of death by an estimated 36% (HR 0.64, 95%CI 0.37-1.11).

CONCLUSION:

High mortality in the first months of anti-tuberculosis treatment could be reduced by addressing diagnostic delays, particularly for extra-pulmonary and smear-negative TB cases and, in HIV-infected patients, by initiation of ART soon after starting anti-tuberculosis treatment.

PMID:
22871326
DOI:
10.5588/ijtld.11.0613
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Ingenta plc
    Loading ...
    Support Center