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Estimating tuberculosis case mortality in England and Wales, 2001–2002

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SETTING: England and Wales, 2001–2002.

OBJECTIVE: To obtain a more accurate estimate of tuberculosis (TB) case fatality within 12 months of starting treatment or notification among TB cases reported to the national surveillance system.

METHODS: Records of deaths for all TB cases reported to the national surveillance system were identified using linkage to two other sources of mortality information: the National Health Service (NHS) central register and death registrations from the Office for National Statistics (ONS). These data were compared to reports of deaths ascertained by national TB surveillance through treatment outcome monitoring. Capture-recapture methodology was used to estimate any remaining unascertained deaths for the final calculation of the case fatality rate (CFR).

RESULTS: In total, 1169 deaths (95%CI 1140–1224) were identified among 13176 cases (CFR 8.9%, 95%CI 8.7–9.3%). Data linkage with the NHS central register and death registrations from the ONS identified a further 255 deaths not recorded by national TB surveillance. Capture-recapture estimated 61 (95%CI 32–116) unascertained deaths.

CONCLUSION: Mortality among TB cases is underestimated by national TB surveillance. Real-time data linkage between case reports and death registrations would allow a more accurate and timely estimate of TB mortality.

Keywords: capture-recapture; mortality; surveillance; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Respiratory Diseases, Health Protection Agency Centre for Infections, London, UK 2: Department of Immunisation, Health Protection Agency Centre for Infections, London, UK 3: Department of Statistics Modelling & Bioinformatics, Health Protection Agency Centre for Infections, London, UK

Publication date: March 1, 2008

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