Mortality, TB/HIV co-infection, and treatment dropout: predictors of tuberculosis prognosis in Recife, Pernambuco State, Brazil
Mortality, TB/HIV co-infection, and treatment dropout: predictors of tuberculosis prognosis in Recife, Pernambuco State, Brazil
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DOI：
10.1590/s0102-311x2008000400020
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发表时间：
2008-04-01
期刊：
影响因子：
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通讯作者：
Colosimo, Enrico Antônio
中科院分区：
文献类型：
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作者：
Domingos, Mirian Pereira;Caiaffa, Waleska Teixeira;Colosimo, Enrico Antônio
这项非同期队列研究的目的是在巴西的一个大型人口数据库中确定结核病死亡率的预测因素。结核病、死亡和TB/HIV病例分别从结核病监测数据库（希南/TB）、死亡数据库（SIM）和希南/AIDS数据库中进行5年验证。分析包括具有相对风险估计的比例风险模型。在报告的5 451名结核病患者中，320人（5.9%）死亡（发病率和死亡率分别为每10万居民98.6人和12.2人）。调整后，50岁以上的人死于结核病的相对风险为9.8;结核病/艾滋病毒合并感染为9.0;混合结核病临床表现为3.0;治疗退出为2.0。在多变量模型中，使用HIV/AIDS病例，除混合临床表现外，所有调整的预测因子均失去显著性（RR 1.9; 1.1-3.1）。结核病/艾滋病毒合并感染是结核病死亡率的一个重要预测因素。然而，在未感染艾滋病毒/艾滋病的个人中，死亡率仍然与年龄较大、临床形式混杂和治疗中断密切相关。
This non-concurrent cohort study aims to identify predictors of tuberculosis mortality in a large population database in Brazil. Tuberculosis, death, and TB/HIV cases were validated respectively from the tuberculosis surveillance (SINAN/TB), mortality (SIM), and SINAN/AIDS databases for a five-year period. Analysis included proportional hazard models with relative risk estimates. Out of 5,451 individuals reported with tuberculosis, 320 (5.9%) died (incidence and mortality rates of 98.6 and 12.2/100 thousand inhabitants, respectively). After adjustment, relative risk of dying from tuberculosis was 9.8 for individuals > 50 years of age; 9.0 for TB/HIV co-infection; 3.0 for mixed TB clinical presentation; and 2.0 for treatment dropout. In the multivariate model, using cases with HIV/AIDS, all adjusted predictors lost significance except mixed clinical presentation (RR 1.9; 1.1-3.1). TB/HIV co-infection is an important predictor of TB mortality. However, among individuals without HIV/AIDS, mortality is still highly associated with older age, mixed clinical forms, and treatment dropout.