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Volume 8, Number 11—November 2002

Research

Tuberculosis-Related Deaths within a Well-Functioning DOTS Control Program

Maria de Lourdes García-García*, Alfredo Ponce-de-León†, Maria Cecilia García-Sancho‡, Leticia Ferreyra-Reyes*, Manuel Palacios-Martínez*, Javier Fuentes§, Midori Kato-Maeda†, Miriam Bobadilla†, Peter Small¶, and Jose Sifuentes-Osornio†
Author affiliations: *Instituto Nacional de Salud Pública, Cuernavaca, México; †Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán,” México City, México; ‡Instituto Nacional de Enfermedades Respiratorias, México City, Mexico; §Secretaría de Salud del Estado de Veracruz, Xalapa, México; ¶Stanford University, Palo Alto, California, USA;

Main Article

Table 1

Sociodemographic, clinical, bacteriologic, and therapeutic characteristics of smear-positive pulmonary tuberculosis (TB) patients according to cause of death, Orizaba, Veracruz, 1995–2000

Variables Died from TB
(n=34) (%) Died from other causes
(n=47) (%) Survived
(n=373) (%) p valuea
Sociodemographic
Median age (range) 30 (24–73) 47 (22–70) 40.5 (12–82) 0.05
Men 52.9 76.6 57.9 0.04
Indigenous origin 20.6 4.3 16.1 0.07
<6 years formal education 73.5 76.6 62.2 0.02
Rural and industrial workers 11.8 25.5 23.6 0.2
Previous imprisonment 14.7 34.0 27.9 0.2
Previous TB treatment 47.1 34.0 14.2 <0.0001
Previous hospitalization 58.8 51.1 45.6 0.2
Residence in shelters 5.9 10.6 5.1 0.3
Alcohol use 38.2 66.0 43.7 0.005
Household crowding 47.1 27.7 37.5 0.2
Household with earthen floor 20.6 10.6 16.6 0.4
Clinical
HIV infection 8.8 10.6 .3 <0.0001
Hepatic cirrhosis 0 6.4 1.3 0.06
Body mass index (<18) 47.1 27.7 20.4 <0.0001
Hemoptysis 26.5 38.3 37.8 0.5
Fever 44.1 61.7 44 0.04
Night sweats 58.8 59.6 57.6 0.2
Weight loss (>15 %) 47.1 46.8 29.2 0.002
Radiologic nodes 5.9 6.4 7.0 0.9
Cavities 44.1 25.5 33.2 0.2
Median time interval between initiation of symptoms and treatment (range in days) 17 (1–212) 8 (0–158) 5 (0–322) 0.004
Median time interval between diagnosis and treatment (range in days) 141.5 (78–991) 126 (4–439) 99.5 (4–1,723) 0.01
Bacteriologic
Resistance to isoniazid and rifampin 29.4 17.0 2.1 <0.0001
Other resistance 11.8 19.1 12.9 0.2
<10 bacilli per 100 fields 79.4 87.2 86.1 0.5
Median time interval between treatment and sputum conversion (range in days) 95 (35–530) 44 (19–182) 42.5 (15–348) 0.03
Treatment outcome
Cure 5.9 61.7 87.4 <0.0001
Failure 20.6 10.6 2.1 <0.0001
Default 32.4 10.6 6.7 <0.0001
Retreatment 17.6 23.4 5.4 <0.0001

aChi square test, analysis of variance test.

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