Mortality of tuberculosis patients in Chennai, India
Mortality of tuberculosis patients in Chennai, India
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DOI：
10.2471/blt.05.022087
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发表时间：
2006-07-10
期刊：
影响因子：
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通讯作者：
Narayanan, PR
中科院分区：
文献类型：
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作者：
Kolappan, C;Subramani, R;Narayanan, PR
目的测量印度南部金奈集团诊所结核病患者的死亡率和超额总死亡率，并确定死亡的高危人群。方法在这项回顾性队列研究中，我们跟踪了2000年在金奈集团诊所进行DOTS策略登记和治疗的2674名患者(男1800人，女874人)。从开始治疗到面谈或死亡的随访期为600天，发现这群结核病患者的死亡率为60/1000人年。以标化死亡率比(SMR)表示的超额总死亡率为6.1(95%可信区间=5.4~6.9)。与其他人群相比，年轻患者、男性、11类疾病患者、拖欠或失败疗程的患者以及男性吸烟者的死亡率都较高。结论该队列的超额死亡率是普通人群的6倍。年龄小、男性、涂阳、未接受治疗、治疗失败以及吸烟和酗酒是结核病死亡的危险因素。我们建议将死亡率和超额死亡率作为评价国家控制方案效率的常规监测工具。
Objective We aimed to measure the mortality rate and excess general mortality as well as identify groups at high risk for mortality among a cohort of tuberculosis patients treated in Chennai Corporation clinics in south India.Methods In this retrospective cohort study we followed up 2674 patients (1800 males and 874 females) who were registered and treated under the DOTS strategy in Chennai Corporation clinics in 2000. The follow-up period from the date of start of treatment to either the date of interview, or death was 600 days.Findings The mortality rate among this cohort of tuberculosis patients was 60/1000 person-years. The excess general mortality expressed as standardized mortality ratio (SMR) was 6.1 (95% confidence interval (CI) = 5.4-6.9). Younger patients, men, patients with Category 11 disease, patients who defaulted on, or failed courses of treatment, and male smokers who were alcoholics, all had higher mortality ratios when compared to the rest of the cohort.Conclusion The excess mortality in this cohort was six times more than that in the general population. Young age, male sex, smear-positivity, treatment default, treatment failure and the combination of smoking and alcoholism were identified as risk factors for tuberculosis mortality. We suggest that mortality rate and excess mortality be routinely used as a monitoring tool for evaluating the efficiency of the national control programme.