Siame Lukundo, Chembe Eemmanuel, Muchaili Lweendo, Hamooya Benson M, Masenga Sepiso K
School of Medicine and Healt3h Sciences, Mulun3gushi University, Livingstone, Zambia.
PLOS Glob Public Health. 2024 Oct 14;4(10):e0003686. doi: 10.1371/journal.pgph.0003686. eCollection 2024.
Tuberculosis (TB) mortality remains a significant public health concern globally. This study aimed to determine the prevalence of tuberculosis-related deaths and associated factors among patients at Livingstone University Teaching Hospital (LUTH) Chest Clinic, Zambia. We conducted a retrospective cross-sectional study among 694 individuals (507 adult and 187 children) diagnosed with drug susceptible TB disease between January 1, 2021, and December 31, 2022. Demographic and clinical information were collected from medical records using a data collection form. Multivariable logistic regression was used to determine factors associated with TB-related death. Statistical significance was set at p < 0.05. STATA version 15 was used for all data analysis. The prevalence of TB-related death among adults (above 19 years old) was 18.4% (n = 93) whereas that in children (below 19 years old) was 7.0% (n = 187). Living with HIV (AOR 1.75, 95% CI 1.00-3.08, p = 0.049) was positively associated with TB-related death among the adult patients while being on a family based direct observation therapy (DOT) plan was negatively associated with TB-related death both among adults and among children, (AOR 0.24, 95% CI 0.13-0.45, p <0.001) and (AOR 0.2, 95% CI 0.03-0.99, p = 0.039) respectively. This study found a high TB-related mortality rate, both among adults and children, exceeding the national target of 5% and it was significantly associated with HIV status and DOT plan. There is therefore a need to enhance strategies aimed at reducing TB-related deaths, especially among those living with HIV.
结核病（TB）死亡率仍是全球重大的公共卫生问题。本研究旨在确定赞比亚利文斯通大学教学医院（LUTH）胸部诊所患者中结核病相关死亡的患病率及相关因素。我们对2021年1月1日至2022年12月31日期间诊断为药物敏感结核病的694名个体（507名成人和187名儿童）进行了一项回顾性横断面研究。使用数据收集表从医疗记录中收集人口统计学和临床信息。采用多变量逻辑回归来确定与结核病相关死亡的因素。设定统计学显著性为p<0.05。所有数据分析均使用STATA 15版本。成人（19岁以上）中结核病相关死亡的患病率为18.4%（n = 93），而儿童（19岁以下）为7.0%（n = 187）。感染艾滋病毒（调整后比值比[AOR]为1.75，95%置信区间[CI]为1.00 - 3.08，p = 0.049）与成年患者中结核病相关死亡呈正相关，而接受家庭直接观察治疗（DOT）计划与成人和儿童中的结核病相关死亡均呈负相关，分别为（AOR 0.24，95% CI 0.13 - 0.45，p<0.001）和（AOR 0.2，95% CI 0.03 - 0.99，p = 0.039）。本研究发现，成人和儿童中结核病相关死亡率都很高，超过了5%的国家目标，并且与艾滋病毒感染状况和DOT计划显著相关。因此，有必要加强旨在降低结核病相关死亡的策略，特别是在艾滋病毒感染者中。
