Pulmonary tuberculosis in adults: factors associated with mortality at a Ghanaian teaching hospital.
Identifieur interne : 000747 ( PubMed/Corpus ); précédent : 000746; suivant : 000748Pulmonary tuberculosis in adults: factors associated with mortality at a Ghanaian teaching hospital.
Auteurs : S D Lawn ; J W AcheampongSource :
- West African journal of medicine [ 0189-160X ]
English descriptors
- KwdEn :
- AIDS-Related Opportunistic Infections (mortality), Adult, Age Distribution, Aged, Cause of Death, Female, Ghana (epidemiology), Hospital Mortality, Hospitals, Teaching, Humans, Male, Middle Aged, Radiography, Residence Characteristics (statistics & numerical data), Retrospective Studies, Risk Factors, Survival Analysis, Time Factors, Treatment Outcome, Tuberculosis, Pulmonary (diagnostic imaging), Tuberculosis, Pulmonary (mortality), Tuberculosis, Pulmonary (therapy).
- MESH :
- diagnostic imaging : Tuberculosis, Pulmonary.
- epidemiology : Ghana.
- mortality : AIDS-Related Opportunistic Infections, Tuberculosis, Pulmonary.
- statistics & numerical data : Residence Characteristics.
- therapy : Tuberculosis, Pulmonary.
- Adult, Age Distribution, Aged, Cause of Death, Female, Hospital Mortality, Hospitals, Teaching, Humans, Male, Middle Aged, Radiography, Retrospective Studies, Risk Factors, Survival Analysis, Time Factors, Treatment Outcome.
Abstract
Tuberculosis (TB) is a leading cause of global mortality. The aim of this study was to compare factors associated with poor outcome (death) and good outcome (cure) of adult patients receiving treatment for pulmonary TB (PTB) at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. The case notes and chest radiographs of 80 such patients who died were retrospectively reviewed and compared to 80 patients who were cured during the same period. Patients who died were 3.4 times more likely to be HIV-positive (p < 0.001). Mortality was also associated with increased age (p < 0.001), residence in a rural area (p < 0.05) sputum smear-negative disease (p < 0.01), and more prolonged symptom duration prior to initial diagnosis (p < 0.05). Furthermore, patients who died were 2.1 times more likely to have a history of previous TB treatment (p < 0.01), 2.0 times more likely to have previously defaulted from treatment ((p < 0.05), and 2.9 times more likely to have > or = 5 chest radiographic zones affected by disease (p < 0.001). In conclusion, although mortality among patients with PTB is strongly associated with HIV infection in this community, other factors identified reflect late diagnosis, poor treatment compliance and inadequate resources for diagnosis and treatment of TB in rural areas. Improved rates of diagnosis, enhancement of treatment compliance and decentralization of TB services to the district level may therefore help to reduce mortality from TB.
PubMed: 10734790
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pubmed:10734790Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Pulmonary tuberculosis in adults: factors associated with mortality at a Ghanaian teaching hospital.</title><author><name sortKey="Lawn, S D" sort="Lawn, S D" uniqKey="Lawn S" first="S D" last="Lawn">S D Lawn</name><affiliation><nlm:affiliation>Division of Infectious Diseases, St. George's Hospital Medical School, London, U.K.</nlm:affiliation></affiliation></author><author><name sortKey="Acheampong, J W" sort="Acheampong, J W" uniqKey="Acheampong J" first="J W" last="Acheampong">J W Acheampong</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="????"><PubDate><MedlineDate>1999 Oct-Dec</MedlineDate></PubDate></date><idno type="RBID">pubmed:10734790</idno><idno type="pmid">10734790</idno><idno type="wicri:Area/PubMed/Corpus">000747</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000747</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Pulmonary tuberculosis in adults: factors associated with mortality at a Ghanaian teaching hospital.</title><author><name sortKey="Lawn, S D" sort="Lawn, S D" uniqKey="Lawn S" first="S D" last="Lawn">S D Lawn</name><affiliation><nlm:affiliation>Division of Infectious Diseases, St. George's Hospital Medical School, London, U.K.</nlm:affiliation></affiliation></author><author><name sortKey="Acheampong, J W" sort="Acheampong, J W" uniqKey="Acheampong J" first="J W" last="Acheampong">J W Acheampong</name></author></analytic><series><title level="j">West African journal of medicine</title><idno type="ISSN">0189-160X</idno></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>AIDS-Related Opportunistic Infections (mortality)</term><term>Adult</term><term>Age Distribution</term><term>Aged</term><term>Cause of Death</term><term>Female</term><term>Ghana (epidemiology)</term><term>Hospital Mortality</term><term>Hospitals, Teaching</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Radiography</term><term>Residence Characteristics (statistics & numerical data)</term><term>Retrospective Studies</term><term>Risk Factors</term><term>Survival Analysis</term><term>Time Factors</term><term>Treatment Outcome</term><term>Tuberculosis, Pulmonary (diagnostic imaging)</term><term>Tuberculosis, Pulmonary (mortality)</term><term>Tuberculosis, Pulmonary (therapy)</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Tuberculosis, Pulmonary</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Ghana</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>AIDS-Related Opportunistic Infections</term><term>Tuberculosis, Pulmonary</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Residence Characteristics</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Tuberculosis, Pulmonary</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Age Distribution</term><term>Aged</term><term>Cause of Death</term><term>Female</term><term>Hospital Mortality</term><term>Hospitals, Teaching</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Radiography</term><term>Retrospective Studies</term><term>Risk Factors</term><term>Survival Analysis</term><term>Time Factors</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Tuberculosis (TB) is a leading cause of global mortality. The aim of this study was to compare factors associated with poor outcome (death) and good outcome (cure) of adult patients receiving treatment for pulmonary TB (PTB) at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. The case notes and chest radiographs of 80 such patients who died were retrospectively reviewed and compared to 80 patients who were cured during the same period. Patients who died were 3.4 times more likely to be HIV-positive (p < 0.001). Mortality was also associated with increased age (p < 0.001), residence in a rural area (p < 0.05) sputum smear-negative disease (p < 0.01), and more prolonged symptom duration prior to initial diagnosis (p < 0.05). Furthermore, patients who died were 2.1 times more likely to have a history of previous TB treatment (p < 0.01), 2.0 times more likely to have previously defaulted from treatment ((p < 0.05), and 2.9 times more likely to have > or = 5 chest radiographic zones affected by disease (p < 0.001). In conclusion, although mortality among patients with PTB is strongly associated with HIV infection in this community, other factors identified reflect late diagnosis, poor treatment compliance and inadequate resources for diagnosis and treatment of TB in rural areas. Improved rates of diagnosis, enhancement of treatment compliance and decentralization of TB services to the district level may therefore help to reduce mortality from TB.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">10734790</PMID><DateCreated><Year>2000</Year><Month>04</Month><Day>12</Day></DateCreated><DateCompleted><Year>2000</Year><Month>04</Month><Day>12</Day></DateCompleted><DateRevised><Year>2016</Year><Month>11</Month><Day>24</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0189-160X</ISSN><JournalIssue CitedMedium="Print"><Volume>18</Volume><Issue>4</Issue><PubDate><MedlineDate>1999 Oct-Dec</MedlineDate></PubDate></JournalIssue><Title>West African journal of medicine</Title><ISOAbbreviation>West Afr J Med</ISOAbbreviation></Journal><ArticleTitle>Pulmonary tuberculosis in adults: factors associated with mortality at a Ghanaian teaching hospital.</ArticleTitle><Pagination><MedlinePgn>270-4</MedlinePgn></Pagination><Abstract><AbstractText>Tuberculosis (TB) is a leading cause of global mortality. The aim of this study was to compare factors associated with poor outcome (death) and good outcome (cure) of adult patients receiving treatment for pulmonary TB (PTB) at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. The case notes and chest radiographs of 80 such patients who died were retrospectively reviewed and compared to 80 patients who were cured during the same period. Patients who died were 3.4 times more likely to be HIV-positive (p < 0.001). Mortality was also associated with increased age (p < 0.001), residence in a rural area (p < 0.05) sputum smear-negative disease (p < 0.01), and more prolonged symptom duration prior to initial diagnosis (p < 0.05). Furthermore, patients who died were 2.1 times more likely to have a history of previous TB treatment (p < 0.01), 2.0 times more likely to have previously defaulted from treatment ((p < 0.05), and 2.9 times more likely to have > or = 5 chest radiographic zones affected by disease (p < 0.001). In conclusion, although mortality among patients with PTB is strongly associated with HIV infection in this community, other factors identified reflect late diagnosis, poor treatment compliance and inadequate resources for diagnosis and treatment of TB in rural areas. Improved rates of diagnosis, enhancement of treatment compliance and decentralization of TB services to the district level may therefore help to reduce mortality from TB.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lawn</LastName><ForeName>S D</ForeName><Initials>SD</Initials><AffiliationInfo><Affiliation>Division of Infectious Diseases, St. George's Hospital Medical School, London, U.K.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Acheampong</LastName><ForeName>J W</ForeName><Initials>JW</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Nigeria</Country><MedlineTA>West Afr J Med</MedlineTA><NlmUniqueID>8301891</NlmUniqueID><ISSNLinking>0189-160X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><CitationSubset>X</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D017088" MajorTopicYN="N">AIDS-Related Opportunistic Infections</DescriptorName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017677" MajorTopicYN="N">Age Distribution</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002423" MajorTopicYN="N">Cause of Death</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005869" MajorTopicYN="N">Ghana</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D017052" MajorTopicYN="Y">Hospital Mortality</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006784" MajorTopicYN="Y">Hospitals, Teaching</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011859" MajorTopicYN="N">Radiography</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012111" MajorTopicYN="N">Residence Characteristics</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016019" MajorTopicYN="N">Survival Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014397" MajorTopicYN="N">Tuberculosis, Pulmonary</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName><QualifierName UI="Q000401" MajorTopicYN="Y">mortality</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2000</Year><Month>3</Month><Day>29</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2000</Year><Month>4</Month><Day>15</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2000</Year><Month>3</Month><Day>29</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">10734790</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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