Patients’ characteristic and factors related to causes of death in new pulmonary Tuberculosis Patients in Lamphun Province

Abstract

Tuberculosis is still a serious public health problem in Thailand. In 2015, the World Health Organization declared Thailand as one of 14 countries with severe TB problem. The success rate of treatment in new pulmonary tuberculosis patients in Lamphun province is proportionally low due to number of mortalities during treatment. This study aims to determine the factors related mortality in new TB cases. The Data from TB-Clinic management (TBCM) were electronically explored retrospectively, 2012-2016. New pulmonary TB cases who registered at TB clinic Lamphun hospital were recruited to this study. Univariate analysis and Odd Ratios were applied to identify the risk factors associated with fatal outcome with 95 % Confidence Interval (CI). A total 806 of new TB cases enrolled in this study, male was higher than female (3.1: 1), of these 508/806 (63.0%) were age over 50 years, 52/806 (6.5%) had co-HIV infection, and 203/806 (25.2%) had co-morbidity diseases. TB treatment outcomes, 105/806 (13.0%). reported deaths. The risk factors associated with death were patients with co-morbidity diseases 20.2% (OR 2.1, 95% CI 1.4-3.3) followed by patient age over 50 years 17.3% (OR 3.5, 95% CI 2.0-5.9). The co-morbidity diseases between survival and death were classified into renal disease 42.9) (OR 5.1, 95% CI 1.1-23.2, p<0.05), cancer 37.5% (OR 4.1, 95% CI 1.0-17.4, p<0.05), COPD 33.3% (OR 3.7, 95%CI 1.9-7.3,p<0.05), and hypertension 23.5%,(OR 2.4, 95% CI 1.4-4.0,p<0.05) respectively. Moreover, patients dying during the first 2 months was 2.6 time higher than the last 4 months. We concluded that the highest risk factors of dying during tuberculosis treatment were a co-morbidity diseases and aging. Managing TB as well as underlying co-morbidities in a multidisciplinary approach is essential to improve the outcome of patient in an aging population.