Author/Authors :
Alavi‑Naini, Roya Department of Infectious Diseases - Infectious Diseases and Tropical Medicine Research Center - Zahedan University of Medical Sciences, Zahedan, Iran , Moghtaderi, Ali Department of Infectious Diseases - Infectious Diseases and Tropical Medicine Research Center - Zahedan University of Medical Sciences, Zahedan, Iran , Metanat, Maliheh Department of Infectious Diseases - Infectious Diseases and Tropical Medicine Research Center - Zahedan University of Medical Sciences, Zahedan, Iran , Mohammadi, Mehdi Department of Infectious Diseases - Infectious Diseases and Tropical Medicine Research Center - Zahedan University of Medical Sciences, Zahedan, Iran , Zabetian, Mahnaz Department of Infectious Diseases - Infectious Diseases and Tropical Medicine Research Center - Zahedan University of Medical Sciences, Zahedan, Iran
Abstract :
Background: Tuberculosis (TB) is one of the main causes of morbidity and mortality in different societies. Understanding factors
leading to death following diagnosis of TB is important to predict prognosis in TB patients. The aim of this study was to identify
common risk factors associated with death in patients with an in‑hospital diagnosis of TB, in a city in Iran with the highest prevalence
and incidence of TB in the country. Materials and Methods: A retrospective study was conducted at a university‑affiliated hospital,
Zahedan, in the south‑east of Iran, which is a referral center for TB. To identify factors leading to death, medical records of 715 patients
≥15 years old with pulmonary TB from February 2002 to February 2011 have been evaluated. Registered factors included smoking,
human immune deficiency virus (HIV) infection, using drugs, lung cancer, drug hepatitis following anti‑TB medications, diabetes
mellitus, previous TB treatment, anemia; and results of sputum smears. Univariate comparison and multiple logistic regression were
performed to identify factors associated with mortality in TB patients. Results: Among 715 registered TB patients, 375 (52.5%) patients
were male; among those, 334 (53%) were in the alive group and 41 (54%) in the death group. Seventy‑five (10.5%) of the total number
of TB patients died during TB treatment. The multivariate model showed that anemia (AOR: 19.8, 95% CI: 5.6‑35.5), positive sputum
smear (AOR: 13.4, 95% CI: 6.8‑33.6), smoking (AOR: 12.9, 95% CI: 3.9‑27.3), drug hepatitis (AOR: 12.3, 95% CI: 6.7‑24.7), diabetes
mellitus (AOR: 9.7, 95% CI: 2.9‑32.0), drug use (AOR: 7.8, 95% CI: 2.4‑25.5), and history of previous TB (AOR: 6.8, 95% CI: 2.2‑21.3)
were major risk factors for death in TB patients. Conclusion: Monitoring co‑morbid conditions like diabetes mellitus and anemia
are important to reduce death rate in TB patients. Preventive measures for smoking and drug addiction also play an important role
to decrease mortality. Follow‑up of patients with previous TB treatment is recommended.
