Department of Community and Family Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia.
TB/Leprosy Unit, Sabah State Health Department, Ministry of Health, Putrajaya 62590, Malaysia.
Int J Environ Res Public Health. 2021 Sep 16;18(18):9740. doi: 10.3390/ijerph18189740.
Tuberculosis (TB) is a leading killer from a single infectious agent globally. In 2019, Malaysia's TB incidence rate was 92 per 100,000 population, and the TB mortality rate was estimated at 4 cases per 100,000 population per year. However, the state of Sabah had a higher burden of TB with a notification rate of 128 per 100,000 population and a TB case fatality rate of 8% compared to the national figure. This study aims to provide a comprehensive report on TB deaths epidemiology and its associated factors at a sub-national level. This nested case-control study used Sabah State Health Department TB surveillance data from the Malaysia national case-based TB registry (MyTB) between 2014 and 2018. Cases were defined as all-cause TB deaths that occurred before anti-TB treatment completion from the time of TB diagnosis. Controls were randomly selected from TB patients who completed anti-TB treatment. The TB mortality rate had increased significantly from 9.0/100,000 population in 2014 to 11.4/100,000 population in 2018. The majority of TB deaths occurred in the first two months of treatment. TB-related deaths were primarily due to advanced disease or disseminated TB, whereas non-TB-related deaths were primarily due to existing comorbidities. Many important independent risk factors for TB deaths were identified which are useful to address the increasing TB mortality rate.
结核病（TB）是全球单一感染源导致的主要杀手。2019 年，马来西亚的结核病发病率为每 10 万人 92 例，结核病死亡率估计为每年每 10 万人 4 例。然而，沙巴州的结核病负担更重，通报率为每 10 万人 128 例，结核病病死率为 8%，高于全国水平。本研究旨在提供一份关于国家以下一级结核病死亡流行病学及其相关因素的综合报告。这项嵌套病例对照研究使用了 2014 年至 2018 年期间马来西亚全国基于病例的结核病登记处（MyTB）中沙巴州卫生部结核病监测数据。病例定义为从结核病诊断到抗结核治疗完成前所有原因导致的结核病死亡。对照为完成抗结核治疗的结核病患者中随机选择。结核病死亡率从 2014 年的每 10 万人 9.0 例显著上升至 2018 年的每 10 万人 11.4 例。大多数结核病死亡发生在治疗的头两个月。结核病相关死亡主要是由于疾病进展或播散性结核病，而非结核病相关死亡主要是由于现有合并症。确定了许多结核病死亡的重要独立危险因素，这些因素有助于解决结核病死亡率不断上升的问题。
