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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Mortality among tuberculosis patients in the Democratic Republic of Congo
International Journal of Tuberculosis and Lung Disease, Volume 16, No. 9, Year 2012
Notification
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Description
SETTING: Kinshasa, Democratic Republic of Congo. OBJECTIVE: To identify programmatic interventions for improved survival in patients receiving treatment for tuberculosis (TB) at primary care clinics. DESIGN: Retrospective cohort of adult patients initiating anti-tuberculosis treatment between January 2006 and May 2007. RESULTS: Among 5685 patients, 390 deaths occurred during anti-tuberculosis treatment, of which half (52%) did so during the first 2 months. Patients with smear-negative pulmonary TB were at greater risk of death in the first 2 months of treatment (human immunodeficiency virus [HIV] positive HR 1.49, 95%CI 0.89-2.49; HIV-negative HR 1.77 95%CI 1.06-2.95), but not thereafter. Patients with extra-pulmonary TB were at increased risk of death in the first 2 months of anti-tuberculosis treatment if they were non-HIV-infected (HR 2.42, 95%CI 1.52-3.85), and were half as likely to die during the remainder of treatment (HIV-positive HR 0.46, 95%CI 0.22-0.97; HIV-negative HR 0.47, 95%CI 0.23-0.94). Antiretroviral therapy (ART) reduced the risk of death by an estimated 36% (HR 0.64, 95%CI 0.37-1.11). CONCLUSION: High mortality in the first months of anti-tuberculosis treatment could be reduced by addressing diagnostic delays, particularly for extra-pulmonary and smear-negative TB cases and, in HIV-infected patients, by initiation of ART soon after starting antituberculosis treatment. © 2012 The Union.
Authors & Co-Authors
Henegar, Cassidy E.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Behets, Frieda M.T.F.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Vanden Driessche, K.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Tabala, Martine
Democratic Republic Congo, Kinshasa
Universite de Kinshasa
Bahati, Etienne R.
Congo
National Tuberculosis Program
Bola, V.
Congo
National Tuberculosis Program
Van Ri, A.
United States, Chapel Hill
The University of North Carolina at Chapel Hill
Statistics
Citations: 31
Authors: 7
Affiliations: 3
Identifiers
Doi:
10.5588/ijtld.11.0613
ISSN:
10273719
Research Areas
Infectious Diseases
Study Design
Cohort Study
Study Locations
Congo