Abstract:
Abstract
Background: Tuberculosis (TB) is the main cause of death from a sole infectious agent
worldwide. Tanzania is among the 30 high burden countries with a mortality of 47 per
100,000 population and a case fatality of 4%. Although there are many studies conducted on
TB mortality rate and risk factors using routine data from other countries, inconsistent findings
from various studies prompted further studies to be conducted to assess whether factors
reported in previous studies are applicable in our local setting.
Objectives: This study intended to determine the mortality rate, survival probabilities, and
factors associated with death among TB patients.
Methodology: A retrospective cohort study was conducted utilizing national TB program data
of all TB cases registered from January 2017 to December 2017. Kaplan-Meier estimator was
used to determine survival probabilities and an extended Cox proportional model was used to
identify independent risk factors of death among TB patients. Hazard ratios and 95%
confidence intervals are presented.
Results: Among 61,979 patients, 2114 (3.4%) patients died during TB treatment giving a
mortality rate of 6.0 per 1000 person-months. The independent risk factors for death among TB patients included older age ≥60 years (aHR = 2.51, 95% CI = 2.11-2.99), accessing service
at the hospital level (aHR = 1.15, 95% CI = 1.04-1.27), TB/HIV Co-infection (aHR = 2.89,
95% CI = 2.61- 3.20), and facility-based DOT option (aHR = 2.25, 95% CI = 1.83 - 2.79).
Other factors were sputum negative results (aHR =1.37, 95% CI = 1.21-1.58), having
extrapulmonary TB (aHR =1.21, 95% CI = 1.08-1.34), being referred from other sources (aHR
=1.48, 95% CI = 1.22- 1.80), residing in southern highland zone (aHR =1.73, 95% CI = 1.38-
2.18), Southern Zone (aHR =1.57, 95% CI = 1.22-2.01) and western zone (aHR =1.54, 95% CI = 1.21-1.97). Conclusion: We identified several independent predictors of death among TB patients among
different risk groups. To achieve the milestone of reducing TB mortality by 2035, it is critical
to formulate appropriately targeted interventions on the prompt detection, diagnosis, and
appropriate referral of TB patients among the risk groups
