Jabir Yasin Negash, Aniley Tafere Tilahun, Bacha Reta Habtamu, Debusho Legesse Kassa, Chikako Teshita Uke, Hagan John Elvis, Seidu Abdul-Aziz, Ahinkorah Bright Opoku
Department of Statistics, College of Natural Sciences, Jimma University, Jimma P.O. Box 378, Ethiopia.
Department of Statistics, University of South Africa (UNISA), Christiaan de Wet Road & Pioneer Avenue, Johannesburg 1709, South Africa.
Diseases. 2022 Aug 5;10(3):51. doi: 10.3390/diseases10030051.
(1) Background: Tuberculosis is a bacterial disease mainly caused by . It is one of the major public health problems in the world and now ranks alongside human immunodeficiency virus (HIV) as the leading infectious cause of death. The objective of this study was to investigate the potential risk factors affecting the time to death of TB patients in southwest Ethiopia using parametric shared frailty models. (2) Methods: A retrospective study design was used to collect monthly records of TB patients in three selected hospitals in southwest Ethiopia. The data used in the study were obtained from patients who took part in the directly observed treatment, short-course (DOTS) program from 1 January 2015 to 31 December 2019. The survival probability was analyzed by the Kaplan-Meier method. Log-rank tests and parametric shared frailty models were applied to investigate factors associated with death during TB treatment. (3) Results: Out of the total sample of 604 registered TB patients, 46 (7.6%) died during the study period and 558 (92.4%) were censored. It was found that the median time of death for TB patients was 5 months. Hospitals were used to assess the cluster effect of the frailty model. A Gamma shared frailty model with Weibull distribution for baseline hazard function was selected among all models considered and was used for this study. It was found that the covariates, age, initial weight, extrapulmonary type of TB patient, patient category, and HIV status of TB patient were significant risk factors associated with death status among TB patients. (4) Conclusions: The risk of death was high, especially with cases of HIV co-infected, retreated, and returned-after-treatment categories of TB patients. During the treatment period, the risk of death was high for older TB patients and patients with low baseline body weight measurements. Therefore, health professionals should focus on the identified factors to improve the survival time of TB patients.
(1) 背景：结核病是一种主要由……引起的细菌性疾病。它是世界上主要的公共卫生问题之一，目前与人类免疫缺陷病毒（HIV）并列成为主要的感染性死亡原因。本研究的目的是使用参数共享脆弱模型调查影响埃塞俄比亚西南部结核病患者死亡时间的潜在风险因素。(2) 方法：采用回顾性研究设计，收集埃塞俄比亚西南部三家选定医院结核病患者的月度记录。本研究使用的数据来自于2015年1月1日至2019年12月31日参加直接观察治疗短程疗法（DOTS）项目的患者。通过Kaplan-Meier方法分析生存概率。应用对数秩检验和参数共享脆弱模型来调查结核病治疗期间与死亡相关的因素。(3) 结果：在604例登记的结核病患者总样本中，46例（7.6%）在研究期间死亡，558例（92.4%）被截尾。发现结核病患者的中位死亡时间为5个月。使用医院来评估脆弱模型的聚类效应。在所有考虑的模型中，选择了具有Weibull分布作为基线危险函数的Gamma共享脆弱模型用于本研究。发现协变量年龄、初始体重、肺外型结核病患者、患者类别以及结核病患者的HIV状态是与结核病患者死亡状态相关的重要风险因素。(4) 结论：死亡风险很高，特别是对于合并感染HIV、复治以及治疗后返回的结核病患者。在治疗期间，老年结核病患者和基线体重测量值低的患者死亡风险很高。因此，卫生专业人员应关注已确定的因素，以提高结核病患者的生存时间。
