Survival time among patients who were diagnosed with tuberculosis, the precocious deaths and associated factors in southern Brazil

Danielle Talita dos Santos, Luiz Henrique Arroyo, Yan Mathias Alves, Luana Seles Alves, Thais Zamboni Berra, Juliane de Almeida Crispim, Josilene Dália Alves, Denisse Andrea Cartagena Ramos, Jonas Bodini Alonso, Ivaneliza Simionato de Assis, Antônio Vieira Ramos, Elma Mathias Dessunti, Ione Carvalho Pinto, Pedro Fredemir Palha, Ricardo Alexandre Arcêncio, Carla Nunes

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2 Citations (Scopus)

Abstract

Background: A diagnosis of tuberculosis (TB) does not mean that the disease will be treated successfully, since death may occur even among those who are known to the health services. Here, we aimed to analyze patient survival time from the diagnosis of TB to death, precocious deaths, and associated factors in southern Brazil. Methods: We conducted a longitudinal study with patients who were diagnosed with TB and who died due to the disease between 2008 and 2015 in southern Brazil. The starting point for measuring survival time was the patient’s diagnosis date. Techniques for survival analysis were employed, including the Kaplan-Meier test and Cox’s regression. A mixed-effect model was applied for identifying the associated factors to precocious deaths. Hazard ratio (HR) and odds ratio (OR) with 95% confidence intervals (95% CI) were estimated. We defined p value <0.05 as statistically significant for all statistics applied. Results: One hundred forty-six patients were included in the survival analysis, observing a median survival time of 23.5 days. We observed that alcoholism (HR=1.55, 95% CI=1.04-2.30) and being male (HR=6.49, 95% CI=1.03-2.68) were associated with death. The chance of precocious death within 60 days was 10.48 times greater than the chance of early death within 30 days. Conclusion: Most of the deaths occurred within 2 months after the diagnosis, during the intensive phase of the treatment. The use of alcohol and gender were associated with death, revealing inequality between men and women. This study advanced knowledge regarding the vulnerability associated with mortality. These findings must be addressed to fill a gap in the care cascades for active TB and ensure equity in health.

Original languageEnglish
Article number31
JournalTropical Medicine and Health
Volume49
Issue number1
DOIs
Publication statusPublished - 2021

Keywords

  • HIV
  • Mortality
  • Risk factors
  • Survival analysis
  • Tuberculosis

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