Factors associated with mortality and default among patients with tuberculosis attending a teaching hospital clinic in Accra, Ghana.
Identifieur interne : 000826 ( Main/Exploration ); précédent : 000825; suivant : 000827Factors associated with mortality and default among patients with tuberculosis attending a teaching hospital clinic in Accra, Ghana.
Auteurs : Nicole T. Burton [États-Unis] ; Audrey Forson ; Mark N. Lurie ; Samuel Kudzawu ; Ernest Kwarteng ; Awewura KwaraSource :
- Transactions of the Royal Society of Tropical Medicine and Hygiene [ 1878-3503 ] ; 2011.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Analyse multivariée, Antituberculeux (usage thérapeutique), Co-infection, Connaissances, attitudes et pratiques en santé, Dossiers médicaux, Facteurs de risque, Femelle, Ghana (épidémiologie), Humains, Hôpitaux d'enseignement, Infections à VIH (mortalité), Infections à VIH (psychologie), Infections à VIH (traitement médicamenteux), Jeune adulte, Modèles logistiques, Mâle, Observance thérapeutique (), Odds ratio, Résultat thérapeutique, Sujet âgé, Tuberculose (mortalité), Tuberculose (psychologie), Tuberculose (traitement médicamenteux), Études rétrospectives, Évaluation des risques.
- MESH :
- mortalité : Infections à VIH, Tuberculose.
- psychologie : Infections à VIH, Tuberculose.
- traitement médicamenteux : Infections à VIH, Tuberculose.
- usage thérapeutique : Antituberculeux.
- épidémiologie : Ghana.
- Adolescent, Adulte, Adulte d'âge moyen, Analyse multivariée, Co-infection, Connaissances, attitudes et pratiques en santé, Dossiers médicaux, Facteurs de risque, Femelle, Humains, Hôpitaux d'enseignement, Jeune adulte, Modèles logistiques, Mâle, Observance thérapeutique, Odds ratio, Résultat thérapeutique, Sujet âgé, Études rétrospectives, Évaluation des risques.
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
- Adolescent, Adult, Aged, Antitubercular Agents (therapeutic use), Coinfection, Female, Ghana (epidemiology), HIV Infections (drug therapy), HIV Infections (mortality), HIV Infections (psychology), Health Knowledge, Attitudes, Practice, Hospitals, Teaching, Humans, Logistic Models, Male, Medical Records, Middle Aged, Multivariate Analysis, Odds Ratio, Patient Compliance (statistics & numerical data), Retrospective Studies, Risk Assessment, Risk Factors, Treatment Outcome, Tuberculosis (drug therapy), Tuberculosis (mortality), Tuberculosis (psychology), Young Adult.
- MESH :
- chemical , therapeutic use : Antitubercular Agents.
- geographic , epidemiology : Ghana.
- drug therapy : HIV Infections, Tuberculosis.
- mortality : HIV Infections, Tuberculosis.
- psychology : HIV Infections, Tuberculosis.
- statistics & numerical data : Patient Compliance.
- Adolescent, Adult, Aged, Coinfection, Female, Health Knowledge, Attitudes, Practice, Hospitals, Teaching, Humans, Logistic Models, Male, Medical Records, Middle Aged, Multivariate Analysis, Odds Ratio, Retrospective Studies, Risk Assessment, Risk Factors, Treatment Outcome, Young Adult.
Abstract
Tuberculosis (TB) remains a major cause of mortality despite availability of effective chemotherapy. This study was performed to identify contributing factors for poor outcome during anti-tuberculosis treatment at a teaching hospital chest clinic. Medical records of registered patients treated for TB between 1 January and 31 December, 2009 were reviewed and abstracted for demographic, clinical and outcome data. Risk factors for mortality during therapy were assessed using bivariate and multivariate logistics approaches. Of 599 patients, 355 (58.9%) completed therapy and/or were cured, 192 (32.1%) died, and 39 (6.5%) defaulted. In multivariate analysis, independent risk factors for mortality included pulmonary cases for which sputum smear status was unknown (odds ratio [OR] 13.7; 95% confidence interval [CI] 6.0, 31.4), HIV coinfection (OR, 3.6; 95% CI 2.4, 5.4), disseminated TB (OR, 2.2; 95% CI 1.0, 4.9), TB meningitis (OR, 2.8; 95% CI 1.5, 5.3), not having a treatment supporter (OR, 2.0; 95% CI 1.3, 3.1), and low body weight (OR, 11.0; 95% CI 3.1, 38.6). Not having a treatment supporter (OR, 3.2; 95% CI 1.6, 6.6) and HIV coinfection (OR, 2.4; 95% CI 1.2, 5.2) were also independently associated with treatment default. Our findings suggest that enhanced measures to reduce mortality and default in TB patients with HIV coinfection, disseminated or meningeal disease and those who have no treatment supporters may help improve treatment outcomes in Ghana.
DOI: 10.1016/j.trstmh.2011.07.017
PubMed: 21920570
Affiliations:
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Le document en format XML
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Burton</name><affiliation wicri:level="2"><nlm:affiliation>Department of Community Health, Warren Alpert Medical School at Brown University, Providence, RI 02906, USA. nicole burton@brown.edu</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Community Health, Warren Alpert Medical School at Brown University, Providence, RI 02906</wicri:regionArea><placeName><region type="state">Rhode Island</region></placeName></affiliation></author><author><name sortKey="Forson, Audrey" sort="Forson, Audrey" uniqKey="Forson A" first="Audrey" last="Forson">Audrey Forson</name></author><author><name sortKey="Lurie, Mark N" sort="Lurie, Mark N" uniqKey="Lurie M" first="Mark N" last="Lurie">Mark N. 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de risque</term><term>Femelle</term><term>Ghana (épidémiologie)</term><term>Humains</term><term>Hôpitaux d'enseignement</term><term>Infections à VIH (mortalité)</term><term>Infections à VIH (psychologie)</term><term>Infections à VIH (traitement médicamenteux)</term><term>Jeune adulte</term><term>Modèles logistiques</term><term>Mâle</term><term>Observance thérapeutique ()</term><term>Odds ratio</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Tuberculose (mortalité)</term><term>Tuberculose (psychologie)</term><term>Tuberculose (traitement médicamenteux)</term><term>Études rétrospectives</term><term>Évaluation des risques</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antitubercular Agents</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Ghana</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>HIV 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xml:lang="fr"><term>Ghana</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Coinfection</term><term>Female</term><term>Health Knowledge, Attitudes, Practice</term><term>Hospitals, Teaching</term><term>Humans</term><term>Logistic Models</term><term>Male</term><term>Medical Records</term><term>Middle Aged</term><term>Multivariate Analysis</term><term>Odds Ratio</term><term>Retrospective Studies</term><term>Risk Assessment</term><term>Risk Factors</term><term>Treatment Outcome</term><term>Young Adult</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Analyse multivariée</term><term>Co-infection</term><term>Connaissances, attitudes et pratiques en santé</term><term>Dossiers médicaux</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Hôpitaux d'enseignement</term><term>Jeune adulte</term><term>Modèles logistiques</term><term>Mâle</term><term>Observance thérapeutique</term><term>Odds ratio</term><term>Résultat thérapeutique</term><term>Sujet âgé</term><term>Études rétrospectives</term><term>Évaluation des risques</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Ghana</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Tuberculosis (TB) remains a major cause of mortality despite availability of effective chemotherapy. This study was performed to identify contributing factors for poor outcome during anti-tuberculosis treatment at a teaching hospital chest clinic. Medical records of registered patients treated for TB between 1 January and 31 December, 2009 were reviewed and abstracted for demographic, clinical and outcome data. Risk factors for mortality during therapy were assessed using bivariate and multivariate logistics approaches. Of 599 patients, 355 (58.9%) completed therapy and/or were cured, 192 (32.1%) died, and 39 (6.5%) defaulted. In multivariate analysis, independent risk factors for mortality included pulmonary cases for which sputum smear status was unknown (odds ratio [OR] 13.7; 95% confidence interval [CI] 6.0, 31.4), HIV coinfection (OR, 3.6; 95% CI 2.4, 5.4), disseminated TB (OR, 2.2; 95% CI 1.0, 4.9), TB meningitis (OR, 2.8; 95% CI 1.5, 5.3), not having a treatment supporter (OR, 2.0; 95% CI 1.3, 3.1), and low body weight (OR, 11.0; 95% CI 3.1, 38.6). Not having a treatment supporter (OR, 3.2; 95% CI 1.6, 6.6) and HIV coinfection (OR, 2.4; 95% CI 1.2, 5.2) were also independently associated with treatment default. Our findings suggest that enhanced measures to reduce mortality and default in TB patients with HIV coinfection, disseminated or meningeal disease and those who have no treatment supporters may help improve treatment outcomes in Ghana.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Rhode Island</li></region></list><tree><noCountry><name sortKey="Forson, Audrey" sort="Forson, Audrey" uniqKey="Forson A" first="Audrey" last="Forson">Audrey Forson</name><name sortKey="Kudzawu, Samuel" sort="Kudzawu, Samuel" uniqKey="Kudzawu S" first="Samuel" last="Kudzawu">Samuel Kudzawu</name><name sortKey="Kwara, Awewura" sort="Kwara, Awewura" uniqKey="Kwara A" first="Awewura" last="Kwara">Awewura Kwara</name><name sortKey="Kwarteng, Ernest" sort="Kwarteng, Ernest" uniqKey="Kwarteng E" first="Ernest" last="Kwarteng">Ernest Kwarteng</name><name sortKey="Lurie, Mark N" sort="Lurie, Mark N" uniqKey="Lurie M" first="Mark N" last="Lurie">Mark N. Lurie</name></noCountry><country name="États-Unis"><region name="Rhode Island"><name sortKey="Burton, Nicole T" sort="Burton, Nicole T" uniqKey="Burton N" first="Nicole T" last="Burton">Nicole T. Burton</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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