Abstract
Identify the treatment effects and risk factors for mortality in patients with pulmonary tuberculosis receiving antituberculosis treatment under the Directly Observed Treatment Short-Course (DOTS) program to reduce the mortality rate of tuberculosis. A retrospective cohort analysis was conducted on the outcomes of antituberculosis treatment of 7,032 patients with tuberculosis in the DOTS program, in the Tuberculosis Management Information System from 2014 to 2017 in Tianjin, China. The Kaplan–Meier method and multifactor Cox proportional risk regression model were used to analyze the risk factors for mortality during antituberculosis treatment under DOTS. The success rate of antituberculosis treatment was 90.24% and the mortality rate was 4.56% among 7,032 cases of tuberculosis in Tianjin. Cox regression analysis showed that advanced age, male sex, human immunodeficiency virus (HIV) positivity, first sputum positivity, retreated tuberculosis, and a delayed visit (≥14 days) were risk factors for mortality in patients with pulmonary tuberculosis receiving antituberculosis treatment under DOTS. The treatment effects in patients with pulmonary tuberculosis during antituberculosis treatment under DOTS were positive in Tianjin. Advanced age, male sex, HIV positivity, first sputum positivity, retreated tuberculosis, and a delayed visit (≥14 days) increased the risk for mortality during antituberculosis treatment.
Highlights
Tuberculosis (TB) is a chronic respiratory infectious disease caused by Mycobacterium tuberculosis
Survival analysis combines the outcomes of the event and follow-up time [16]
A total of 321 patients died during treatment, with a mortality rate of 4.6%, which was higher than those in Kaili City (2.1%) and Guangzhou (2.8%) [17], but lower than those in Ethiopia (12.71%) [18], India (6%) [19], and Nigeria (16.6%) [20]. e 1-year survival rate was 94.1% after antituberculosis treatment, and the greatest reduction in the cumulative survival rate was observed in the 2 months of antituberculosis treatment
Summary
Tuberculosis (TB) is a chronic respiratory infectious disease caused by Mycobacterium tuberculosis. E World Health Organization’s 2019 Global Tuberculosis Report indicated an estimated 10 million new patients with TB worldwide, an estimated global TB death toll of 1.24 million, and a mortality rate of 16/100,000 individuals in 2018 [1]. China has approximately 900,000 new patients with TB annually, ranking 3rd among 30 countries with high TB burdens worldwide [2]. In 2018, the number of TB-related deaths in China was 37,000 and the mortality rate was 2.6/ 100,000 individuals, ranking 29th among 30 countries with high TB burdens [1]. TB is the third leading cause of death among major infectious diseases and more than 70% of deaths among patients with TB occur in the first 2 months of TB treatment [4, 5]. TB is the third leading cause of death among major infectious diseases and more than 70% of deaths among patients with TB occur in the first 2 months of TB treatment [4, 5]. erefore, it is important to explore the risk factors of TB death under the DOTS strategy
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