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Application of Cox Proportional Hazards Model in Case of Tuberculosis Patients in Selected Addis Ababa Health Centres, Ethiopia

DOI: 10.1155/2014/536976

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Abstract:

Introduction. Tuberculosis (TB) is a chronic infectious disease and mainly caused by mycobacterium tuberculosis (MTB). It has been one of the major causes of mortality in Ethiopia. The objective of the study was to identify factors that affect the survival of the patients with tuberculosis who started treatment for tuberculosis. Methods. This was a retrospective study in six randomly selected health centres in Addis Ababa, Ethiopia. The data were obtained from medical records of TB patients registered from September 2012 to August 2013 and treated under directly observed treatment surgery (DOTS) strategy. Kaplan Meier plots, logrank tests, and Wilcoxon tests were used to assess the survival pattern. Cox proportional hazards model for multivariable analysis was discussed. Results. Out of the total 826 registered TB patients, 105 (12.71%) died during the study period and 712 (87.29%) were censored. Based on Kaplan Meier survival curves, logrank test, and Wilcoxon test, it was found that the patients had statistically significant differences in survival experience with respect to age, body weight at initiation of treatment, TB patient category, and HIV status. Multivariable Cox hazards regression analysis revealed that the covariates age, TB patient category, HIV, and age by HIV interaction were significant risk factors associated with death status in TB patients. Conclusion. Deaths of individuals with diseases especially HIV coinfected and nonnew TB cases were high. Therefore, this needs to strengthen the follow-up of patients with TB treatment from the day of anti-TB treatment initiation to completion days. 1. Introduction Tuberculosis (TB) is the leading cause of death from a single bacterial species among adults around the world. The World Health Organization (WHO) estimated that one-third of the world population is infected with Mycobacterium tuberculosis, with 9.4 million new cases and 1.3 million deaths in 2009 [1]. Reducing death, eliminating disease, and preventing the development of drug-resistant TB are the major goals of TB control [2]. TB-related death is often referred to as a TB control indicator [3]. Although the developed countries in Europe and North America have well-equipped treatment facilities and provide free and sufficient anti-TB drugs, treatment success rates there are still below WHO’s goal of 85%, which may be because of the relatively high death rates. In those countries, TB cases are found in the relatively higher age group and are associated with comorbidities [4]. In previous studies, even in developed countries with good

References

[1]  “Global Tuberculosis Control: Surveillance, Planning, Financing,” WHO Report, World Health Organization, Geneva, Switzerland, 2010.
[2]  “Treatment of Tuberculosis: Guidelines for National Programmes,” WHO Report, World Health Organization, Geneva, Switzerland, 2009.
[3]  C. Kolappan, R. Subramani, K. Karunakaran, and P. R. Narayanan, “Mortality of tuberculosis patients in Chennai, India,” Bulletin of the World Health Organization, vol. 84, no. 7, pp. 555–560, 2006.
[4]  A. Faustini, A. J. Hall, and C. A. Perucci, “Tuberculosis treatment outcomes in Europe: a systematic review,” European Respiratory Journal, vol. 26, no. 3, pp. 503–510, 2005.
[5]  K. K. Oursler, R. D. Moore, W. R. Bishai, S. M. Harrington, D. S. Pope, and R. E. Chaisson, “Survival of patients with pulmonary tuberculosis: clinical and molecular epidemiologic factors,” Clinical Infectious Diseases, vol. 34, no. 6, pp. 752–759, 2002.
[6]  R. S. Gore, “Kentucky Epidemiologic Notes and Reports: TB Control Program Condensed from CDC National Center for HIV, STD and TB Prevention, Division of TB Elimination,” Presented on World Tuberculosis Day, vol. 40, no. 2, 2005.
[7]  D. W. Hosmer and S. Lemeshow, Applied Survival Analysis Regression Modeling of Time to Event Data, John Wiley and Sons, New York, NY, USA, 1999.
[8]  D. Collett, Modelling Survival Data in Medical Research, Chapman and Hall, London, UK, 2nd edition, 2003.
[9]  E. Arjas, “A graphical method for assessing goodness of fit in Cox’s proportional Hazards model,” Journal of the American Statistical Association, vol. 83, pp. 204–212, 1988.
[10]  H. Y. Lo, J. Suo, H. J. Chang, S. L. Yang, and P. Chou, “Risk factors associated with death in a 12-month cohort analysis of tuberculosis patients: 12-month follow-up after registration,” Asia-Pacific Journal of Public Health. In press.
[11]  G. Pardeshi, “Survival analysis and risk factors for death in tuberculosis patients on directly observed treatment-short course,” Indian Journal of Medical Sciences, vol. 63, no. 5, pp. 180–186, 2009.
[12]  B. Getahun, G. Ameni, S. Biadgilign, and G. Medhin, “Mortality and associated risk factors in a cohort of tuberculosis patients treated under DOTS programme in Addis Ababa, Ethiopia,” BMC Infectious Diseases, vol. 11, article 127, 2011.
[13]  D. J. Horne, R. Hubbard, M. Narita, A. Exarchos, D. R. Park, and C. H. Goss, “Factors associated with mortality in patients with tuberculosis,” BMC Infectious Diseases, vol. 10, article 258, 2010.
[14]  M. D. F. P. M. de Albuquerque, J. D. L. Batista, R. A. D. A. Ximenes, M. S. Carvalho, G. T. N. Diniz, and L. C. Rodrigues, “Risk factors associated with death in patients who initiate treatment for tuberculosis after two different follow-up periods,” Revista Brasileira de Epidemiologia, vol. 12, no. 4, pp. 513–522, 2009.
[15]  M. P. Domingos, W. T. Caiaffa, and E. A. Colosimo, “Mortality, TB/HIV co-infection, and treatment dropout: predictors of tuberculosis prognosis in Recife, Pernambuco State, Brazil,” Cadernos de Saude Publica, vol. 24, no. 4, pp. 887–896, 2008.
[16]  T. Vasankari, P. Holmstr?m, J. Ollgren, K. Liippo, M. Kokki, and P. Ruutu, “Risk factors for poor tuberculosis treatment outcome in Finland: a cohort study,” BMC Public Health, vol. 7, article 291, 2007.
[17]  A. D. Harries, N. J. Hargreaves, F. Gausi, J. H. Kwanjana, and F. M. Salaniponi, “High early death rate in tuberculosis patients in Malawi,” International Journal of Tuberculosis and Lung Disease, vol. 5, no. 11, pp. 1000–1005, 2001.
[18]  M. Mu?oz-Sellart, L. E. Cuevas, M. Tumato, Y. Merid, and M. A. Yassin, “Factors associated with poor tuberculosis treatment outcome in the Southern Region of Ethiopia,” International Journal of Tuberculosis and Lung Disease, vol. 14, no. 8, pp. 973–979, 2010.
[19]  M. W. Borgdorff, J. Veen, N. A. Kalisvaart, and N. Nagelkerke, “Mortality among tuberculosis patients in the netherlands in the period 1993–1995,” European Respiratory Journal, vol. 11, no. 4, pp. 816–820, 1998.
[20]  M. Vasantha, P. G. Gopi, and R. Subramani, “Survival of tuberculosis patients treated under DOTS in a rural Tuberculosis Unit (TU), south India,” The Indian journal of tuberculosis, vol. 55, no. 2, pp. 64–69, 2008.
[21]  T. A. Mathew, T. N. Ovsyanikova, S. S. Shin et al., “Causes of death during tuberculosis treatment in Tomsk Oblast, Russia,” International Journal of Tuberculosis and Lung Disease, vol. 10, no. 8, pp. 857–863, 2006.
[22]  M. Demissie and D. Kebede, “Defaulting from tuberculosis treatment at the Addis Abeba tuberculosis centre and factors associated with it,” Ethiopian Medical Journal, vol. 32, no. 2, pp. 97–106, 1994.
[23]  S. Low, L. W. Ang, J. Cutter et al., “Mortality among tuberculosis patients on treatment in Singapore,” International Journal of Tuberculosis and Lung Disease, vol. 13, pp. 328–334, 2009.

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