Survival and associated mortality risk factors among post-treatment pulmonary tubercolosis patients in the northwest of China

X.-H. Wang, A.-G. Ma, X.-X. Han, H. Liang, D. Wang, E. Schouten, F. Kok

School of Public Health, Medical College of Qingdao University, Qingdao, China. maaiguo425@163.com

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• Infectious Diseases

OBJECTIVE: The tuberculosis (TB) program was carried out in the Changji zone in northwest of China. Directly Observed Treatment, Short-Course (DOTS) is a modern control strategy against tuberculosis recommended by World Health Organization. The purpose of this work is to describe the survival of post-treatment TB (PTB) patients and to identify the risk factors associated with mortality and treatment outcomes, so that effective measures and interventions could be used to decrease the mortality rate.

PATIENTS AND METHODS: Registry of 4501 TB patients at Center for Disease Control and Prevention (CDC) treated from 2007 to 2014 were collected. Mortality was used as an outcome measure and calculated per 100 person years of observation (PYO) from the date of completion of the treatment to the date of interview if the patients were alive or to the date of death. Kaplan-Meier and Cox regression methods were used to determine the survival and hazard ratios. An indirect method of standardization was used to calculate the standard mortality ratio (SMR).

RESULTS: The average PYO was 5.0 and the total was 21851. Mortality per 100 PYO was 1.9/100 PYO [223/11871] for smear-positive, 3.4/100 PYO [305/9048] for smear-negative and 2.4/100 PYO [22/932] for EPTB cases. Univariate and Cox regression analysis showed that age (p < 0.01), education (p < 0.01), occupation (p < 0.01) and economic status (p < 0.01) were associated with increased mortality.

DISCUSSION: Since the mortality rate was higher in Post-treatment TB patients than the general population these patients need special health care. An integrated survival and associated mortality risk factors and information system is necessary for TB surveillance, personal health status and treatment management. Further studies are required to identify the causes of death in these patients.

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