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      Risk factors for mortality among inpatients with smear positive pulmonary tuberculosis

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          Abstract

          Objective:

          To evaluate risk factors having significant effect on mortality of smear positive Pulmonary Tuberculosis (PTB) inpatients

          Methods:

          A descriptive cross-sectional study was conducted at Ojha Institute of Chest Diseases, Dow University Hospital Ojha Campus, Karachi. One hundred and seventy (170) inpatients of smear positive PTB confirmed by Acid Fast Bacilli (AFB) smear, aged between 13-80 years were enrolled by using consecutive sampling technique while patients with drug resistant Tuberculosis (TB) and extra pulmonary TB were excluded from the study. Selected patients were interviewed for collecting demographic data and risk factor data by using a standard questionnaire.

          Results:

          Out of 170 PTB inpatients, mortality was observed in 23 (13.5%) patients among which male patients were 12 (52.2%), and female were 11 (47.8%). Mortality was significantly associated with increasing age (p=0.003), socioeconomic status (p=0.019), anemia (p=0.03), Chronic Liver Disease (CLD) (p=0.005), Diabetes Mellitus (DM) (p=0.001), Human Immunodeficiency Virus (HIV) (p=0.007), Hypertension (HTN) (p=0.006), recurrent TB (p=0.001), and smoking (p=0.001).

          Conclusion:

          Increasing age, poverty, smoking history, and presence of comorbidities like DM, CLD, HIV, hypertension, and anemia are associated with higher mortality in smear positive PTB cases.

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          The WHO 2014 Global tuberculosis report—further to go

          Alimuddin Zumla, Andrew George, Virendra Sharma … (2015)
          Article 0 comments Cited 164 times – based on 0 reviews     Review now
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            The global tuberculosis epidemic and progress in care, prevention, and research: an overview in year 3 of the End TB era

            Katherine Floyd, Philippe Glaziou, Alimuddin Zumla … (2018)
            Tuberculosis is the number one cause of death from infectious disease globally and drug-resistant forms of the disease are a major risk to global health security. On the occasion of World Tuberculosis Day (March 24, 2018), we provide an up-to-date review of the status of the tuberculosis epidemic, recommended diagnostics, drug treatments and vaccines, progress in delivery of care and prevention, progress in research and development, and actions needed to accelerate progress. This Review is presented in the context of the UN Sustainable Development Goals and WHO's End TB Strategy, which share the aim of ending the global tuberculosis epidemic. In 2016, globally there were an estimated 10·4 million new cases of tuberculosis, and 600 000 new cases with resistance to rifampicin (the most powerful first-line drug). All countries and age groups are affected by tuberculosis, but most cases (90%) in 2016 were in adults, and almost two-thirds were accounted for by seven countries: India, Indonesia, China, Philippines, Pakistan, South Africa, and Nigeria. The sex ratio (male to female) was 1·9 and 10% of patients with newly diagnosed tuberculosis were also HIV-positive. There were 1·7 million deaths from tuberculosis in 2016, including 0·4 million deaths among people co-infected with HIV (officially classified as deaths caused by HIV/AIDS). Progress in care and prevention means that the global mortality rate (deaths per 100 000 people per year) is decreasing by 3·4% per year and incidence (new cases per 100 000 people per year) is decreasing by 1·9% per year. From 2000 to 2016, the annual global number of tuberculosis deaths decreased by 24% and the mortality rate declined by 37%. Worldwide, an estimated 53 million deaths were averted through successful treatment. Nonetheless, major gaps in care and prevention remain. For example, the 6·3 million new cases of tuberculosis reported globally in 2016 represented only 61% of the estimated incidence; only one in five of the estimated number of people with drug-resistant tuberculosis was enrolled in treatment. Pipelines for new diagnostics, drugs, and vaccines are progressing, but slowly. Actions needed to accelerate progress towards global milestones and targets for reductions in the burden of tuberculosis disease set for 2020, 2025, 2030, and 2035 include closing coverage gaps in testing, reporting of cases, and overall access to health care, especially in countries that account for the largest share of the global gap; multisectoral efforts to reduce prevalence of major risk factors for infection and disease; and increased investment in research and development.
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              Global Epidemiology of Tuberculosis.

              Philippe Glaziou, Katherine Floyd, Mario Raviglione (2018)
              Tuberculosis (TB) was the underlying cause of 1.3 million deaths among human immunodeficiency virus (HIV)-negative people in 2016, exceeding the global number of HIV/acquired immune deficiency syndrome (AIDS) deaths. In addition, TB was a contributing cause of 374,000 HIV deaths. Despite the success of chemotherapy over the past seven decades, TB is the top infectious killer globally. In 2016, 10.4 million new cases arose, a number that has remained stable since the beginning of the 21th century, frustrating public health experts tasked to design and implement interventions to reduce the burden of TB disease worldwide. Ambitious targets for reductions in the epidemiological burden of TB have been set within the context of the Sustainable Development Goals (SDGs) and the End TB Strategy. Achieving these targets is the focus of national and international efforts, and demonstrating whether or not they are achieved is of major importance to guide future and sustainable investments. This article reviews epidemiological facts about TB, trends in the magnitude of the burden of TB and factors contributing to it, and the effectiveness of the public health response.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Pak J Med Sci
                Journal ID (iso-abbrev): Pak J Med Sci
                Title: Pakistan Journal of Medical Sciences
                Publisher: Professional Medical Publications (Pakistan )
                ISSN (Print): 1682-024X
                ISSN (Electronic): 1681-715X
                Publication date (Print): Sep-Oct 2019
                Volume: 35
                Issue: 5
                Pages: 1361-1365
                Affiliations
                [1 ]Dr. Sidra Hameed, MBBS, DTCD. Chest Unit-II, Ojha Institute of Chest Diseases Dow University of Health Sciences, Karachi, Pakistan
                [2 ]Dr. Faisal Faiyaz Zuberi, MBBS, FCPS (Med), FCPS (Pulm), FCCP (USA). Associate Professor Pulmonology & Head Chest Unit-II, Ojha Institute of Chest Diseases Dow University of Health Sciences, Karachi, Pakistan
                [3 ]Dr. Sagheer Hussain, MBBS. Chest Unit-II, Ojha Institute of Chest Diseases Dow University of Health Sciences, Karachi, Pakistan
                [4 ]Dr. Syed Khalid Ali, MBBS, DTCD, MCPS (Pulm). Chest Unit-II, Ojha Institute of Chest Diseases Dow University of Health Sciences, Karachi, Pakistan
                Author notes
                Correspondence: Dr. Faisal Faiyaz Zuberi Associate Professor Pulmonology & Head Chest Unit-II, Ojha Institute of Chest Diseases, Dow University of Health Sciences, Karachi, Pakistan. E-mail: faisal@ 123456zuberi.net
                Article
                Publisher ID: PJMS-35-1361
                DOI: 10.12669/pjms.35.5.919
                PMC ID: 6717484
                PubMed ID: 31489007
                SO-VID: ca6a2596-043f-453f-aae1-1a470f3b5eb1
                Copyright © Copyright: © Pakistan Journal of Medical Sciences
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 18 April 2019
                Date revision received : 24 June 2019
                Date accepted : 25 June 2019
                Categories
                Subject: Original Article

                Keywords: mortality,smear positive,pulmonary tuberculosis,risk factors,comorbidities
                Data availability:
                Keywords: mortality, smear positive, pulmonary tuberculosis, risk factors, comorbidities

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