Socio-economic and demographic correlates of tuberculosis-related mortality in Homa Bay County, Kenya

Background: In Kenya, tuberculosis (TB) incidence, prevalence and related mortality rates remain high despite the reduction in global rates. The impact is reduced individual work productivity and dispossessing households of the wealth endowments. Locally, Homa Bay County records one of the highest numbers of TB-related deaths despite provision of a standard and effective package of care at no cost in public hospitals in all the 47 counties in Kenya. The reason for this disparity is yet to be explored. Objective: The aim of this study was to outline and analyse the socio-economic and demographic covariates influencing TB-related mortality in Homa Bay County. Design: A probit model was used to determine the correlates and determinants of TB-related mortality. Results: The main risk factor for TB-related death identified in Homa Bay County was TB/Human Immunodeficiency Virus (HIV) co-infection. Severe malnutrition, being male and advanced age were also key predictors of mortality. Conclusion: It is recommended that patients at high risk of death should be identified and provided with a differentiated package of care, including closer follow-up and monitoring to reduce TB-related deaths in Homa Bay County. Further, in such populations with high HIV prevalence, TB screening efforts should be intensified with early diagnosis and treatment for better outcomes.