Nishinari District Public Health Office, Osaka City, Japan.
The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Japan.
Western Pac Surveill Response J. 2021 Sep 16;12(3):25-33. doi: 10.5365/wpsar.2021.12.3.836. eCollection 2021 Jul-Sep.
To determine the characteristics associated with mortality in patients with culture-positive pulmonary tuberculosis (PTB) in Airin, Osaka City, Japan.
The characteristics of patients with culture-positive PTB registered between 2015 and 2018 in Airin, Osaka City, Japan, were compared between those who died of all causes before or during treatment and those who completed treatment.
Of the 241 culture-positive PTB patients eligible for this study, 170 completed treatment, with negative sputum culture tests, and 62 died. The all-cause case fatality rate was 26.7% (62/232). Multivariate analysis showed that mortality was associated with age 70 years, having a positive sputum smear, a body mass index of < 18.5 and serious comorbidities such as cancer and heart and renal disease. Detection of tuberculosis (TB) by screening or in an outpatient department (OPD) for other diseases was inversely associated with mortality.
Detection of PTB by chest X-ray screening and during regular visits to OPDs for other diseases was associated with non-fatal TB and might contribute to early case finding. Therefore, current active TB case finding and health education on regular visits to physicians for other diseases should be strengthened further for the urban poor population of Osaka City, Japan.
确定日本大阪市爱邻町培养阳性肺结核（PTB）患者死亡相关特征。
比较日本大阪市爱邻町 2015 年至 2018 年间登记的培养阳性 PTB 患者在治疗前或治疗期间因各种原因死亡者与完成治疗者的特征。
本研究纳入 241 例培养阳性 PTB 患者，170 例完成治疗，痰培养阴性，62 例死亡。全因病死率为 26.7%（62/232）。多变量分析显示，死亡与年龄≥70 岁、痰涂片阳性、体重指数＜18.5 和癌症、心脏及肾脏疾病等严重合并症有关。因筛查或因其他疾病在门诊就诊时发现结核病与病死率呈负相关。
通过胸部 X 射线筛查和因其他疾病定期就诊时发现的 PTB 与非致死性结核病有关，可能有助于早期发现病例。因此，日本大阪市贫困的城市人口应进一步加强对现有活动性结核病的发现和定期就诊医生进行健康教育。
