Independent predictors of tuberculosis mortality in a high HIV prevalence setting: a retrospective cohort study

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dc.contributor.authorPepper, Dominique J
dc.contributor.authorSchomaker, Michael
dc.contributor.authorWilkinson, Robert J
dc.contributor.authorde Azevedo, Virginia
dc.contributor.authorMaartens, Gary
dc.date.accessioned2021-10-08T11:06:55Z
dc.date.available2021-10-08T11:06:55Z
dc.date.issued2015
dc.description.abstractBackgroundIdentifying those at increased risk of death during TB treatment is a priority in resource-constrained settings. We performed this study to determine predictors of mortality during TB treatment.MethodsWe performed a retrospective analysis of a TB surveillance population in a high HIV prevalence area that was recorded in ETR.net (Electronic Tuberculosis Register). Adult TB cases initiated TB treatment from 2007 through 2009 in Khayelitsha, South Africa. Cox proportional hazards models were used to identify risk factors for death (after multiple imputations for missing data). Model selection was performed using Akaike’s Information Criterion to obtain the most relevant predictors of death.ResultsOf 16,209 adult TB cases, 851 (5.3%) died during TB treatment. In all TB cases, advancing age, co-infection with HIV, a prior history of TB and the presence of both pulmonary and extra-pulmonary TB were independently associated with an increasing hazard of death. In HIV-infected TB cases, advancing age and female gender were independently associated with an increasing hazard of death. Increasing CD4 counts and antiretroviral treatment during TB treatment were protective against death. In HIV-uninfected TB cases, advancing age was independently associated with death, whereas smear-positive disease was protective.ConclusionWe identified several independent predictors of death during TB treatment in resource-constrained settings. Our findings inform resource-constrained settings about certain subgroups of TB patients that should be targeted to improve mortality during TB treatment.
dc.identifier.apacitationPepper, D. J., Schomaker, M., Wilkinson, R. J., de Azevedo, V., & Maartens, G. (2015). Independent predictors of tuberculosis mortality in a high HIV prevalence setting: a retrospective cohort study. <i>AIDS Research and Therapy</i>, 12(1), 174 - 177. http://hdl.handle.net/11427/35118en_ZA
dc.identifier.chicagocitationPepper, Dominique J, Michael Schomaker, Robert J Wilkinson, Virginia de Azevedo, and Gary Maartens "Independent predictors of tuberculosis mortality in a high HIV prevalence setting: a retrospective cohort study." <i>AIDS Research and Therapy</i> 12, 1. (2015): 174 - 177. http://hdl.handle.net/11427/35118en_ZA
dc.identifier.citationPepper, D.J., Schomaker, M., Wilkinson, R.J., de Azevedo, V. & Maartens, G. 2015. Independent predictors of tuberculosis mortality in a high HIV prevalence setting: a retrospective cohort study. <i>AIDS Research and Therapy.</i> 12(1):174 - 177. http://hdl.handle.net/11427/35118en_ZA
dc.identifier.issn1742-6405
dc.identifier.ris TY - Journal Article AU - Pepper, Dominique J AU - Schomaker, Michael AU - Wilkinson, Robert J AU - de Azevedo, Virginia AU - Maartens, Gary AB - BackgroundIdentifying those at increased risk of death during TB treatment is a priority in resource-constrained settings. We performed this study to determine predictors of mortality during TB treatment.MethodsWe performed a retrospective analysis of a TB surveillance population in a high HIV prevalence area that was recorded in ETR.net (Electronic Tuberculosis Register). Adult TB cases initiated TB treatment from 2007 through 2009 in Khayelitsha, South Africa. Cox proportional hazards models were used to identify risk factors for death (after multiple imputations for missing data). Model selection was performed using Akaike’s Information Criterion to obtain the most relevant predictors of death.ResultsOf 16,209 adult TB cases, 851 (5.3%) died during TB treatment. In all TB cases, advancing age, co-infection with HIV, a prior history of TB and the presence of both pulmonary and extra-pulmonary TB were independently associated with an increasing hazard of death. In HIV-infected TB cases, advancing age and female gender were independently associated with an increasing hazard of death. Increasing CD4 counts and antiretroviral treatment during TB treatment were protective against death. In HIV-uninfected TB cases, advancing age was independently associated with death, whereas smear-positive disease was protective.ConclusionWe identified several independent predictors of death during TB treatment in resource-constrained settings. Our findings inform resource-constrained settings about certain subgroups of TB patients that should be targeted to improve mortality during TB treatment. DA - 2015 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - AIDS Research and Therapy LK - https://open.uct.ac.za PY - 2015 SM - 1742-6405 T1 - Independent predictors of tuberculosis mortality in a high HIV prevalence setting: a retrospective cohort study TI - Independent predictors of tuberculosis mortality in a high HIV prevalence setting: a retrospective cohort study UR - http://hdl.handle.net/11427/35118 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/35118
dc.identifier.vancouvercitationPepper DJ, Schomaker M, Wilkinson RJ, de Azevedo V, Maartens G. Independent predictors of tuberculosis mortality in a high HIV prevalence setting: a retrospective cohort study. AIDS Research and Therapy. 2015;12(1):174 - 177. http://hdl.handle.net/11427/35118.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceAIDS Research and Therapy
dc.source.journalissue1
dc.source.journalvolume12
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12981-015-0076-5
dc.subject.otherInfectious Diseases
dc.subject.otherVirology
dc.subject.otherTuberculosis
dc.subject.otherHIV
dc.subject.otherMortality
dc.subject.otherPredictors
dc.subject.otherMultivariate analysis
dc.titleIndependent predictors of tuberculosis mortality in a high HIV prevalence setting: a retrospective cohort study
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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