EPIDEMIOLOGY OF MORTALITY AMONG TUBERCULOSIS PATIENTS ON TREATMENT IN TERENGGANU STATE OF MALAYSIA
Received 2021-02-10; Accepted 2021-10-07; Published 2021-10-29
Keywords:tuberculosis, mortality, treatment, associated factors, Terengganu
Background: Mortality among tuberculosis patients while on treatment is a public health concern in Malaysia. Exploring the risk factors for tuberculosis mortality is important to evaluate the effectiveness of national tuberculosis control programs and to identify vulnerable patients. This study aimed to estimate the 5-year proportion of mortality among tuberculosis patients on treatment and determine its associated factors in Malaysian setting.
Methods: A case-control study was conducted between deceased and survived groups in Terengganu state of Malaysia. All notified cases that fulfilled the inclusion and exclusion criteria from 1st January 2016 until 31st December 2020 were included in the study. Descriptive statistics, simple and multiple logistic regressions were employed for data analysis.
Results: There were 3,603 tuberculosis cases notified and 12.4% of total notified patients had died during their course of treatment. Multiple logistic regression revealed older age, working group, prison inmate, positive HIV status, far advanced lesion on chest radiographs and disseminated form of tuberculosis were the significant factors associated with mortality among tuberculosis patients with an adjusted odds ratio (AOR) 1.06 (95%CI: 1.04, 1.07; p<0.001); 0.48 (95%CI: 0.33, 0.68; p<0.001); 0.26 (95%CI: 0.09, 0.79; p=0.017); 12.18 (95%CI: 7.15, 20.75; p<0.001); 3.56 (95%CI: 1.46, 8.64; p=0.005); and 6.95 (95%CI: 2.02, 23.97; p=0.002), respectively.
Conclusion: About 1 in 10 patients had died during the treatment of tuberculosis in Terengganu attributed to the pinpointed socio-demographic and clinical factors. The identified risk factors were useful in improving the current screening programme and clinical management to avert mortality among vulnerable patients.
All authors agree that the article, if editorially accepted for publication, shall be licensed under the Creative Commons Attribution License 4.0 to allow others to freely access, copy and use research provided the author is correctly attributed, unless otherwise stated. All articles are available online without charge or other barriers to access. However, anyone wishing to reproduce large quantities of an article (250+) should inform the publisher. Any opinion expressed in the articles are those of the authors and do not reflect that of the University of Malaya, 50603 Kuala Lumpur, Malaysia.