Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

Risk factors for mortality in TB patients: a 10-year electronic record review in a South African province

Authors: J Christo Heunis, N Gladys Kigozi, Perpetual Chikobvu, Sonja Botha, HCJ Dingie van Rensburg

Published in: BMC Public Health | Issue 1/2017

Login to get access

Abstract

Background

Since 1990, reduction of tuberculosis (TB) mortality has been lower in South Africa than in other high-burden countries in Africa. This research investigated the influence of routinely captured demographic and clinical or programme variables on death in TB patients in the Free State Province.

Methods

A retrospective review of case information captured in the Electronic TB register (ETR.net) over the years 2003 to 2012 was conducted. Extracted data were subjected to descriptive and logistic regression analyses. The outcome variable was defined as all registered TB cases with ‘died’ as the recorded outcome. The variables associated with increased or decreased odds of dying in TB patients were established. The univariate and adjusted odds ratios (OR and AOR) together with their corresponding 95% confidence intervals (CI) were estimated, taking the clustering effect of the districts into account.

Results

Of the 190,472 TB cases included in the analysis, 30,991 (16.3%) had ‘died’ as the recorded treatment outcome. The proportion of TB patients that died increased from 15.1% in 2003 to 17.8% in 2009, before declining to 15.4% in 2012. The odds of dying was incrementally higher in the older age groups: 8–17 years (AOR: 2.0; CI: 1.5–2.7), 18–49 years (AOR: 5.8; CI: 4.0–8.4), 50–64 years (AOR: 7.7; CI: 4.6–12.7), and ≥65 years (AOR: 14.4; CI: 10.3–20.2). Other factors associated with increased odds of mortality included: HIV co-infection (males – AOR: 2.4; CI: 2.1–2.8; females – AOR: 1.9; CI: 1.7–2.1) or unknown HIV status (males – AOR: 2.8; CI: 2.5–3.1; females – AOR: 2.4; CI: 2.2–2.6), having a negative (AOR: 1.4; CI: 1.3–1.6) or a missing (AOR: 2.1; CI: 1.4–3.2) pre-treatment sputum smear result, and being a retreatment case (AOR: 1.3; CI: 1.2–1.4).

Conclusions

Although mortality in TB patients in the Free State has been falling since 2009, it remained high at more than 15% in 2012. Appropriately targeted treatment and care for the identified high-risk groups could be considered.
Literature
1.
Thacker SB, Stroup DF, Carande-Kulis V, Marks JS, Roy K, Gerberding JL. Measuring the public’s health. Public Health Rep. 2006;121:14–22.PubMedPubMedCentral
2.
Korenromp EL, Bierrenbach AL, Williams BG, Dye C. The measurement and estimation of tuberculosis mortality. Int J Tuberc Lung Dis. 2009;13:283–303.PubMed
3.
Chaisson RE, Martinson NA. Tuberculosis in Africa – Combating an HIV-driven crisis. N Eng J Med. 2008;358(11):1089–92.CrossRef
4.
World Health Organization. Global Tuberculosis Report 2015. Geneva: WHO; 2015.
5.
Churchyard GJ, Mametja LD, Mvusi L, Ndjeka N, Hesseling AC, Reid A, et al. Tuberculosis control in South Africa: successes, challenges and recommendations. S Afr Med J. 2014;104:244–8.CrossRefPubMed
6.
World Health Organization. Global Tuberculosis Report 2014. Geneva: WHO; 2014.
7.
8.
Statistics South Africa. Mid-year population estimates 2015, Statistical release P0302. Pretoria: Stats SA; 2016.
9.
Statistics South Africa. Mortality and causes of death in South Africa 2011, Findings from death notification. Statistical release P0309.3. Pretoria: Stats SA; 2014.
10.
Day C, Gay A. Health and related indicators. In: Padarath A, English R, editors. South African Health Review 2013/14. Durban: Health Systems Trust; 2014. p. 201–346.
11.
Heunis C, Wouters E, Kigozi G, Engelbrecht M, Tsibolane Y, van der Merwe S, et al. Accuracy of tuberculosis routine data and nurses’ views of the TB-HIV information system in the Free State, South Africa. J Assoc Nurses AIDS Care. 2009;22:67–73.CrossRef
12.
Marcy O, Laureillard D, Madec Y, Chan S, Mayaud C, Borand L, et al. Causes and determinants of mortality in HIV-infected adults with tuberculosis: an analysis from the CAMELIA ANRS 1295-CIPRA KH001 Randomized Trial. Clin Infect Dis. 2014;59(3):435–45.CrossRefPubMedPubMedCentral
13.
Van Cutsem G, Ford N, Hildebrand K, Goemaere E, Mathee S, Abrahams M, et al. Correcting for mortality among patients lost to follow up on antiretroviral therapy in South Africa: a cohort analysis. PLoS ONE. 2011;6(2):e14684.CrossRefPubMedPubMedCentral
14.
StataCorp. Stata: Release 12. Statistical Software. College Station, TX: StataCorp; 2011.
15.
Bocquier P, Collinson M, Clark S, Gerritsen A, Kahn K, TollMan S. Ubiquitous burden: the contribution of migration to AIDS and tuberculosis mortality in rural South Africa. African Population Studies. 2014;28(1) Suppl on Population Issues in South Africa:691–701.
16.
Manda SOM, Masenyetse LJ, Lancaster JL, van der Walt ML. Risk of death among HIV co-infected multidrug resistant tuberculosis patients, compared to mortality in the general population of South Africa. J AIDS Clinic Res. 2003;3:7.
17.
Fox MP, Sannec IM, Conradie F, Zeinecker J, Orrell C, Ive P. Initiating patients on antiretroviral therapy at CD4 cell counts above 200 cells/μl is associated with improved treatment outcomes in South Africa. AIDS. 2010;24:2041–50.CrossRefPubMedPubMedCentral
18.
19.
Mabunda TE, Ramalivhana NJ, Dambisya YM. Mortality associated with tuberculosis/HIV co-infection among patients on TB treatment in the Limpopo province, South Africa. Afr Health Sci. 2014;14:849–54.CrossRefPubMedPubMedCentral
20.
Pepper DJ, Schomaker M, Wilkinson RJ, de Azevedo V, Maartens G. Independent predictors of tuberculosis in a high HIV prevalence setting: a retrospective cohort study. AIDS Res Ther. 2015;12:35.CrossRefPubMedPubMedCentral
21.
Negin J, Abimbola S, Marais BJ. Tuberculosis among older adults – time to take notice. Int J Infect Dis. 2015;32:135–7.CrossRefPubMed
22.
23.
Krishnan L, Akande T, Shankar AV, McIntyre KN, Gounder CR, Yang W-T. Gender-related barriers and delays in accessing tuberculosis diagnostic and treatment services: a systematic review of qualitative studies. Tuber Res Treat. 2014;2014:215059.
24.
Mchunu G, van Griensven J, Hinderaker SG, Kizito W, Sikhondze W, Manzi M, et al. High mortality in tuberculosis patients despite HIV interventions in Swaziland. Public Health Action. 2016;6(2):105–10.CrossRefPubMedPubMedCentral
25.
Dilraj A, Bristow CC, Connolly C, Margot B, Dlamini S, Podewils LJ. Validation of sputum smear results in the Electronic TB Register for the management of tuberculosis, South Africa. Int J Tuberc Lung Dis. 2013;17:1317–21.CrossRefPubMedPubMedCentral
26.
Hargreaves NJ, Kadzakumanja O, Whitty CJM, Salaniponi FML, Harries AD, Squire SB. ‘Smear-negative’ pulmonary tuberculosis in a DOTS programme: poor outcomes in an area of high HIV seroprevalence. Int J Tuberc Lung Dis. 2001;5(9):847–54.PubMed
27.
MacPherson P, Dimairo M, Bandason T, Zezai A, Munyati SS, Butterworth AE, et al. Risk factors for mortality in smear-negative tuberculosis suspects: a cohort study in Harare, Zimbabwe. Int J Lung Tuberc Dis. 2011;15(10):1390–96.CrossRef
28.
Waitt CJ, Squire SB. A systematic review of risk factors for death in adults during and after tuberculosis treatment. Int J Tuberc Lung Dis. 2011;15(7):871–85.CrossRefPubMed
29.
Acuña-Villaorduña C, Ayakaka I, Dryden-Peterson S, Nakubulwa S, Worodria W, Reilly N, et al. High mortality associated with retreatment of tuberculosis in a clinic in Kampala, Uganda: A retrospective study. Am J Trop Med Hyg. 2015;93(1):73–5.CrossRefPubMedPubMedCentral
30.
Liew SM, Khoo EM, Ho BK, Lee YK, Mimi O, Fazlina MY, et al. Tuberculosis in Malaysia: predictors of treatment outcomes in a national registry. Int J Tuberc Lung Dis. 2015;19(7):764–71.CrossRefPubMed
31.
32.
Dowdy DW, Davis JL, den Boon S, Walter ND, Katamba A, Cattamanchi A. Population-level impact of same-day microscopy and Xpert MTB/RIF for tuberculosis diagnosis in Africa. PLoS ONE. 2013;8:e70485.CrossRefPubMedPubMedCentral
33.
Van Rie A, Page-Shipp L, Hanrahan CF, Schnippel K, Dansey H, Bassett J, et al. Point-of-care Xpert® MTB/RIF for smear-negative tuberculosis suspects at a primary care clinic in South Africa. Int J Tuberc Lung Dis. 2013;17(3):368–72.CrossRefPubMedPubMedCentral
34.
Gibbons CL, Mangen MJ, Plass D, Havelaar AH, Brooke RJ, Kramarz P, et al. Measuring underreporting and under-ascertainment in infectious disease datasets: a comparison of methods. BMC Public Health. 2014;14:147.CrossRefPubMedPubMedCentral
Metadata
Title
Risk factors for mortality in TB patients: a 10-year electronic record review in a South African province
Authors
J Christo Heunis
N Gladys Kigozi
Perpetual Chikobvu
Sonja Botha
HCJ Dingie van Rensburg
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3972-2

Other articles of this Issue 1/2017

BMC Public Health 1/2017 Go to the issue

Study protocol

A prospective cohort study on ambient air pollution and respiratory morbidities including childhood asthma in adolescents from the western Cape Province: study protocol

Research article

Fatigue in the general population- associations to age, sex, socioeconomic status, physical activity, sitting time and self-rated health: the northern Sweden MONICA study 2014

Research article

Exposure to a community-wide campaign is associated with physical activity and sedentary behavior among Hispanic adults on the Texas-Mexico border

Research article

A study on the influence of internet addiction and online interpersonal influences on health-related quality of life in young Vietnamese

Research article

Examination of youth sexual and reproductive health transitions in Nigeria and Kenya using longitudinal data

Research article

Building the evidence base for stigma and discrimination-reduction programming in Thailand: development of tools to measure healthcare stigma and discrimination