LowBMIincreases all-cause mortality rates in patients with drug-resistant TB

被引:6
作者
Adamashvili, N. [1 ]
Baliashvili, D. [2 ]
Kuchukhidze, G. [1 ]
Salindri, A. D. [3 ]
Kempker, R. R. [4 ]
Blumberg, H. M. [3 ,4 ,5 ]
Lomtadze, N. [6 ]
Avaliani, Z. [6 ]
Magee, M. J. [4 ,5 ]
机构
[1] Natl Ctr Dis Control & Publ Hlth, 99 Kakheti Highway, GE-0198 Tbilisi, Georgia
[2] Emory Univ, Rollins Sch Publ Hlth, Dept Epidemiol, Atlanta, GA 30322 USA
[3] Georgia State Univ, Sch Publ Hlth, Div Epidemiol & Biostat, Atlanta, GA USA
[4] Emory Univ, Sch Med, Dept Med, Div Infect Dis, Atlanta, GA USA
[5] Emory Univ, Hubert Dept Global Hlth, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA
[6] Natl Ctr TB & Lung Dis, Tbilisi, Georgia
基金
美国国家卫生研究院;
关键词
tuberculosis; drug-resistant tuberculosis; TB mortality; loss to follow-up; RISK-FACTORS; FOLLOW-UP; TUBERCULOSIS PATIENTS; PREDICTORS; DEFAULT; DEATH;
D O I
10.5588/ijtld.21.0450
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
BACKGROUND: Loss to follow-up (LTFU) is common among patients with drug-resistant TB (DR-TB) receiving second-line TB treatment; however, little is known about outcomes after LTFU, including mortality. OBJECTIVE : To determine rates of and factors associated with all-cause mortality among patients with DR-TB who were LTFU. METHODS : Retrospective cohort study of adult patients with DR-TB in Georgia who initiated second-line TB treatment during 2011-2014 and were LTFU. Survival analyses were used to estimate all-cause mortality rates and adjusted hazard ratios (aHR). RESULTS : During 2011-2014, 2,437 second-line treatment episodes occurred and 695 patients were LTFU. Among 695 LTFU patients, 143 (21%) died during 2,686 person-years (PY) post-LTFU (all-cause mortality rate 5.1%, 95% CI 4.3-6.0 per 100 PY). In multivariable analysis, low weight (BMI, 18.5 kg/m(2)) at treatment initiation (aHR 3.2, 95% CI 2.24.7), return to treatment after LTFU (aHR 3.1, 95% CI 2.2-4.4), <12 months of treatment (aHR 2.4, 95% CI 1.4-4.1) and a pre-LTFU positive culture (aHR 3.3, 95% CI 2.2- 4.9) were associated with all-cause mortality. CONC LUS ION: High all- cause mortality occurred among patients with DR-TB after LTFU despite a low HIV prevalence. Providing additional assistance for patients during DR-TB treatment to prevent LTFU and use of new and shorter treatment regimens may reduce mortality among LTFU.
引用
收藏
页码:326 / +
页数:9
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