EPIDEMIOLOGY OF MORTALITY AMONG TUBERCULOSIS PATIENTS ON TREATMENT IN TERENGGANU STATE OF MALAYSIA

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Hafizuddin Awang
Goh Soo Ning
Mohd Hanief Ahmad
Kamarul Azhar Mohamed
Muhammad Fahmi Mohd Zuber
Kasemani Embong
Nor Azimi Yunus

Abstract

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.

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Section
Research article
Author Biographies

Hafizuddin Awang, Besut District Health Office, Kampung Raja, 22200 Besut, Terengganu.

Terengganu State Health Department, Wisma Persekutuan, 20920 Kuala Terengganu, Terengganu, Malaysia.

Public Health Medicine Specialist.

Goh Soo Ning, Hulu Terengganu District Health Office, 21700 Kuala Berang, Hulu Terengganu, Terengganu.

Terengganu State Health Department, Wisma Persekutuan, 20920 Kuala Terengganu, Terengganu, Malaysia.

Public Health Medicine Specialist

Mohd Hanief Ahmad, Setiu District Health Office, 22100 Bandar Permaisuri, Setiu, Terengganu.

Setiu District Health Office, Bandar Permaisuri, 22100 Setiu, Terengganu, Malaysia.

Public Health Medicine Specialist.

Kamarul Azhar Mohamed, Setiu District Health Office, 22100 Bandar Permaisuri, Setiu, Terengganu.

Setiu District Health Office, Bandar Permaisuri, 22100 Setiu, Terengganu.

Medical officer

Muhammad Fahmi Mohd Zuber, Setiu District Health Office, 22100 Bandar Permaisuri, Setiu, Terengganu.

Setiu District Health Office, Bandar Permaisuri, 22100 Setiu, Terengganu.

Medical officer.

Kasemani Embong, Terengganu State Health Department, 20920 Kuala Terengganu, Terengganu.

Terengganu State Health Department, Wisma Persekutuan, 20920 Kuala Terengganu, Terengganu, Malaysia.

Public Health Medicine Specialist.

Nor Azimi Yunus, Pahang State Health Department, 25582 Kuantan, Pahang.

Terengganu State Health Department, Wisma Persekutuan, 20920 Kuala Terengganu, Terengganu, Malaysia.

Terengganu State Health Director.