Patients diagnosed with tuberculosis at death or who died during therapy: association with the human immunodeficiency virus
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.
Document Type: Regular Paper
Affiliations: Division of Tuberculosis Elimination, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Publication date: April 1, 2011
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