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Free Content Mortality of tuberculosis patients during treatment in Israel, 2000–2010

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SETTING

Tuberculosis (TB) epidemiology in Israel is similar to that reported from other industrialised countries where most patients are foreign-born.
OBJECTIVES

To assess TB case fatality rate (CFR) and mortality trends during treatment and to identify risk factors associated with mortality.
DESIGN

Retrospective cohort study of all TB patients in Israel diagnosed between 2000 and 2010. Cause of death was classified by TB-specific and non-TB-specific causes.
RESULTS

During the study period, 451 TB patients died during treatment, representing a CFR of 9.9%. Of these, 72.5% died due to TB-related causes, giving a TB-related CFR of 7.2%. Both the overall and TB-related CFR decreased over the study period. Risk factors for death included male sex, older age, human immunodeficiency virus coinfection, culture positivity and multidrug-resistant TB (MDR-TB). Patients aged 65 years comprised 70% of the TB-related deaths, and more than half of these (54.9%) were born in the former Soviet Union, Europe (excluding the former Soviet Union) or the USA.
CONCLUSION

Both the overall and TB-related CFR decreased over the study period. Physicians who treat older male TB patients with MDR-TB or HIV should increase the index of suspicion to include the possibility of a higher risk of mortality.
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Keywords: Israel; case fatality rate; death; mortality; tuberculosis

Document Type: Research Article

Affiliations: 1: Hadassah School of Public Health and Community Medicine, Braun Hebrew University, Jerusalem 2: Hadassah School of Public Health and Community Medicine, Braun Hebrew University, Jerusalem, Department of International Relations, Ministry of Health, Jerusalem 3: Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem 4: Department of Tuberculosis and AIDS, Ministry of Health, Jerusalem, Ramla Department of Health, Ministry of Health, Ramla, Israel

Publication date: 2014-07-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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