Mortality during tuberculosis treatment in South Africa using an 8-year analysis of the national tuberculosis treatment register

Abstract In 2011, the South African HIV treatment eligibility criteria were expanded to allow all tuberculosis (TB) patients lifelong ART. The impact of this change on TB mortality in South Africa is not known. We evaluated mortality in all adults (≥ 15 years old) treated for drug-susceptible TB in...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Muhammad Osman, Cari van Schalkwyk, Pren Naidoo, James A. Seddon, Rory Dunbar, Sicelo S. Dlamini, Alex Welte, Anneke C. Hesseling, Mareli M. Claassens
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a8bd78d5ca3148f89fba1849008f2aa1
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:a8bd78d5ca3148f89fba1849008f2aa1
record_format	dspace
spelling	oai:doaj.org-article:a8bd78d5ca3148f89fba1849008f2aa12021-12-02T17:06:09ZMortality during tuberculosis treatment in South Africa using an 8-year analysis of the national tuberculosis treatment register10.1038/s41598-021-95331-w2045-2322https://doaj.org/article/a8bd78d5ca3148f89fba1849008f2aa12021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95331-whttps://doaj.org/toc/2045-2322Abstract In 2011, the South African HIV treatment eligibility criteria were expanded to allow all tuberculosis (TB) patients lifelong ART. The impact of this change on TB mortality in South Africa is not known. We evaluated mortality in all adults (≥ 15 years old) treated for drug-susceptible TB in South Africa between 2009 and 2016. Using a Cox regression model, we quantified risk factors for mortality during TB treatment and present standardised mortality ratios (SMR) stratified by year, age, sex, and HIV status. During the study period, 8.6% (219,618/2,551,058) of adults on TB treatment died. Older age, male sex, previous TB treatment and HIV infection (with or without the use of ART) were associated with increased hazard of mortality. There was a 19% reduction in hazard of mortality amongst all TB patients between 2009 and 2016 (adjusted hazard ratio: 0.81 95%CI 0.80–0.83). The highest SMR was in 15–24-year-old women, more than double that of men (42.3 in 2016). Between 2009 and 2016, the SMR for HIV-positive TB patients increased, from 9.0 to 19.6 in women, and 7.0 to 10.6 in men. In South Africa, case fatality during TB treatment is decreasing and further interventions to address specific risk factors for TB mortality are required. Young women (15–24-year-olds) with TB experience a disproportionate burden of mortality and interventions targeting this age-group are needed.Muhammad OsmanCari van SchalkwykPren NaidooJames A. SeddonRory DunbarSicelo S. DlaminiAlex WelteAnneke C. HesselingMareli M. ClaassensNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Muhammad Osman Cari van Schalkwyk Pren Naidoo James A. Seddon Rory Dunbar Sicelo S. Dlamini Alex Welte Anneke C. Hesseling Mareli M. Claassens Mortality during tuberculosis treatment in South Africa using an 8-year analysis of the national tuberculosis treatment register
description	Abstract In 2011, the South African HIV treatment eligibility criteria were expanded to allow all tuberculosis (TB) patients lifelong ART. The impact of this change on TB mortality in South Africa is not known. We evaluated mortality in all adults (≥ 15 years old) treated for drug-susceptible TB in South Africa between 2009 and 2016. Using a Cox regression model, we quantified risk factors for mortality during TB treatment and present standardised mortality ratios (SMR) stratified by year, age, sex, and HIV status. During the study period, 8.6% (219,618/2,551,058) of adults on TB treatment died. Older age, male sex, previous TB treatment and HIV infection (with or without the use of ART) were associated with increased hazard of mortality. There was a 19% reduction in hazard of mortality amongst all TB patients between 2009 and 2016 (adjusted hazard ratio: 0.81 95%CI 0.80–0.83). The highest SMR was in 15–24-year-old women, more than double that of men (42.3 in 2016). Between 2009 and 2016, the SMR for HIV-positive TB patients increased, from 9.0 to 19.6 in women, and 7.0 to 10.6 in men. In South Africa, case fatality during TB treatment is decreasing and further interventions to address specific risk factors for TB mortality are required. Young women (15–24-year-olds) with TB experience a disproportionate burden of mortality and interventions targeting this age-group are needed.
format	article
author	Muhammad Osman Cari van Schalkwyk Pren Naidoo James A. Seddon Rory Dunbar Sicelo S. Dlamini Alex Welte Anneke C. Hesseling Mareli M. Claassens
author_facet	Muhammad Osman Cari van Schalkwyk Pren Naidoo James A. Seddon Rory Dunbar Sicelo S. Dlamini Alex Welte Anneke C. Hesseling Mareli M. Claassens
author_sort	Muhammad Osman
title	Mortality during tuberculosis treatment in South Africa using an 8-year analysis of the national tuberculosis treatment register
title_short	Mortality during tuberculosis treatment in South Africa using an 8-year analysis of the national tuberculosis treatment register
title_full	Mortality during tuberculosis treatment in South Africa using an 8-year analysis of the national tuberculosis treatment register
title_fullStr	Mortality during tuberculosis treatment in South Africa using an 8-year analysis of the national tuberculosis treatment register
title_full_unstemmed	Mortality during tuberculosis treatment in South Africa using an 8-year analysis of the national tuberculosis treatment register
title_sort	mortality during tuberculosis treatment in south africa using an 8-year analysis of the national tuberculosis treatment register
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/a8bd78d5ca3148f89fba1849008f2aa1
work_keys_str_mv	AT muhammadosman mortalityduringtuberculosistreatmentinsouthafricausingan8yearanalysisofthenationaltuberculosistreatmentregister AT carivanschalkwyk mortalityduringtuberculosistreatmentinsouthafricausingan8yearanalysisofthenationaltuberculosistreatmentregister AT prennaidoo mortalityduringtuberculosistreatmentinsouthafricausingan8yearanalysisofthenationaltuberculosistreatmentregister AT jamesaseddon mortalityduringtuberculosistreatmentinsouthafricausingan8yearanalysisofthenationaltuberculosistreatmentregister AT rorydunbar mortalityduringtuberculosistreatmentinsouthafricausingan8yearanalysisofthenationaltuberculosistreatmentregister AT sicelosdlamini mortalityduringtuberculosistreatmentinsouthafricausingan8yearanalysisofthenationaltuberculosistreatmentregister AT alexwelte mortalityduringtuberculosistreatmentinsouthafricausingan8yearanalysisofthenationaltuberculosistreatmentregister AT annekechesseling mortalityduringtuberculosistreatmentinsouthafricausingan8yearanalysisofthenationaltuberculosistreatmentregister AT marelimclaassens mortalityduringtuberculosistreatmentinsouthafricausingan8yearanalysisofthenationaltuberculosistreatmentregister
_version_	1718381749700919296

Mortality during tuberculosis treatment in South Africa using an 8-year analysis of the national tuberculosis treatment register

Ejemplares similares