Poor tuberculosis treatment outcomes in Southern Mozambique (2011–2012)

BMC Infectious Diseases

Research Article

Frank Cobelens¹  Durval Respeito²  Orvalho J. Augusto²  Charfudin Sacoor²  Elisa López-Varela³  Quique Bassat³  Pedro L. Alonso³  Alberto L. García-Basteiro⁴  Eusebio Macete⁵  Aina Casellas⁵  Victor G. Sequera⁵  Ivan Manhiça⁶ 

[1] Amsterdam Institute for Global Health and Development, Academic Medical Centre, Amsterdam, The Netherlands;Centro de Investigação em Saude de Manhiça (CISM), Maputo, Mozambique;Centro de Investigação em Saude de Manhiça (CISM), Maputo, Mozambique;ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain;Centro de Investigação em Saude de Manhiça (CISM), Maputo, Mozambique;ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain;Amsterdam Institute for Global Health and Development, Academic Medical Centre, Amsterdam, The Netherlands;ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain;Ministry of Health, National Tuberculosis Program, Maputo, Mozambique;

关键词: Mortality;    Tuberculosis;    Manhiça;    Death;    Adverse outcome;   

DOI  :  10.1186/s12879-016-1534-y

 received in 2015-05-13, accepted in 2016-05-04,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundIn Mozambique, there is limited data regarding the monitoring of Tuberculosis (TB) treatment results and determinants of adverse outcomes under routine surveillance conditions. The objectives of this study were to evaluate treatment outcomes among TB patients, analyze factors associated with a fatal outcome and determine the proportion of deaths attributable to TB in the district of Manhiça, Southern Mozambique.MethodsThis is a retrospective observational study based on TB patients diagnosed in the period 2011–2012. We used three different data sources: a) TB related variables collected by the National TB Control Program in the district of Manhiça for all TB cases starting treatment in the period 2011–2012. b) Population estimates for the district were obtained through the Mozambican National Statistics Institute. c) Deaths and other relevant demographic variables were collected from the Health and Demographic Surveillance System at Manhiça Health Research Center. WHO guidelines were used to define TB cases and treatment outcomes.ResultsOf the 1957 cases starting TB treatment in the period 2011–2012, 294 patients (15.1 %) died during anti-tuberculous treatment. Ten per cent of patients defaulted treatment. The proportion of patients considered to have treatment failure was 1.1 %. HIV infection (OR 2.73; 95 % CI: 1.70–4.38), being female (OR: 1.39; 95 % CI: 1.31–1.91) and lack of laboratory confirmation (OR 1.51; 95 % CI: 1.10–2.08) were associated with dying during the course of TB treatment (p value <0.05). The contribution of TB to the overall death burden of the district for natural reasons was 6.5 % (95 % CI: 5.5–7.6), higher for males than for females (7.8 %; 95 % CI: 6.1–9.5 versus 5.4 %; 95 % CI: 4.1–6.8 respectively). The age group within which TB was responsible for the highest proportion of deaths was 30–34 among males and 20–24 among females (20 % of all deaths in both cases).ConclusionThis study shows a very high proportion of fatal outcomes among TB cases starting treatment. There is a high contribution of TB to the overall causes of mortality. These results call for action in order to improve TB (and TB/HIV) management and thus treatment outcomes of TB patients.

【 授权许可】

CC BY   
© García-Basteiro et al. 2016