Volume 30, Number 11—November 2024
Synopsis
Mortality Rates after Tuberculosis Treatment, Georgia, USA, 2008–2019
Table 3
Characteristics | Univariate analysis, HR (95% CI) | Multivariate model, HR (95% CI)† |
---|---|---|
Age, per year |
1.06 (1.05–1.07) |
1.06 (1.05–1.07) |
Sex | ||
F | Referent | NA |
M |
1.23 (0.92–1.63) |
NA |
US-born persons |
6.68 (4.60–9.70) |
3.42 (2.25–5.19) |
Ethnicity‡ | ||
Non-Hispanic White | Referent | NA |
Non-Hispanic Asian | 0.23 (0.14–0.37) | NA |
Non-Hispanic Black | 0.67 (0.49–0.91) | NA |
Hispanic, all races |
0.12 (0.06–0.23) |
NA |
HIV status | ||
Negative | Referent | Referent |
Positive | 1.70 (1.22–2.45) | 1.87 (1.20–2.90) |
Missing data |
1.72 (1.02–2.92) |
1.58 (0.90–2.78) |
Injection drug use | ||
No | Referent | NA |
Yes | 1.44 (0.55–4.00) | NA |
Missing data |
1.46 (0.36–5.91) |
NA |
Excess alcohol use | ||
No | Referent | Referent |
Yes | 2.38 (1.79–3.15) | 1.64 (1.17–2.30) |
Missing data |
1.30 (0.32–5.26) |
1.51 (0.34–6.75) |
Homeless within past year | ||
No | Referent | Referent |
Yes | 2.19 (1.58–3.04) | 1.36 (0.89–2.08) |
Missing data |
1.81 (0.25–12.90) |
17.3 (2.00–150.0) |
Diabetes mellitus | 2.83 (2.09–3.83) | 2.05 (1.44–2.91) |
End-stage renal disease |
3.36 (1.73–6.54) |
2.24 (1.05–4.80) |
Case verification | ||
Culture confirmed | Referent | NA |
Clinical case | 0.66 (0.47–0.93) | NA |
Other | 1.12 (0.42–3.01) | NA |
Extrapulmonary | 0.62 (0.43–0.91) | NA |
Cavitary disease, n = 2,511§ |
1.14 (0.86–1.50) |
NA |
Sputum smear, n = 2,511§ | ||
Negative | Referent | NA |
Positive | 1.00 (0.76–1.33) | NA |
Missing data |
0.82 (0.41–1.63) |
NA |
Drug susceptibility, n = 2,318 | ||
RIF/INH susceptible | Referent | Referent |
RIF susceptible/INH resistant | 0.99 (0.62–1.57) | 0.89 (0.55–1.49) |
RIF resistant | 0.49 (0.07–3.47) | 0.89 (0.12–6.39) |
Incomplete TB treatment | 0.83 (0.49–1.40) | NA |
*HR, hazard ratio; INH, isoniazid; NA, not applicable; RIF, rifampin; TB, tuberculosis. †Model selected according to best fit of Akaike Information Criterion (21). ‡Other category was excluded because no deaths occurred in this group (n = 55). §Cavitary disease and sputum smear were not included in the multivariable models because the overall cohort included patients without pulmonary disease.
References
- World Health Organization. Global tuberculosis report 2023 [cited 2024 Aug 1]. https://www.who.int/publications/i/item/9789240083851
- Byrne AL, Marais BJ, Mitnick CD, Lecca L, Marks GB. Tuberculosis and chronic respiratory disease: a systematic review. Int J Infect Dis. 2015;32:138–46. DOIPubMedGoogle Scholar
- Huaman MA, Henson D, Ticona E, Sterling TR, Garvy BA. Tuberculosis and cardiovascular disease: linking the epidemics. Trop Dis Travel Med Vaccines. 2015;1:10. DOIPubMedGoogle Scholar
- Romanowski K, Baumann B, Basham CA, Ahmad Khan F, Fox GJ, Johnston JC. Long-term all-cause mortality in people treated for tuberculosis: a systematic review and meta-analysis. Lancet Infect Dis. 2019;19:1129–37. DOIPubMedGoogle Scholar
- Menzies NA, Quaife M, Allwood BW, Byrne AL, Coussens AK, Harries AD, et al. Lifetime burden of disease due to incident tuberculosis: a global reappraisal including post-tuberculosis sequelae. Lancet Glob Health. 2021;9:e1679–87. DOIPubMedGoogle Scholar
- Basham CA, Karim ME, Cook VJ, Patrick DM, Johnston JC. Post-tuberculosis mortality risk among immigrants to British Columbia, Canada, 1985-2015: a time-dependent Cox regression analysis of linked immigration, public health, and vital statistics data. Can J Public Health. 2021;112:132–41. DOIPubMedGoogle Scholar
- Uplekar M, Weil D, Lonnroth K, Jaramillo E, Lienhardt C, Dias HM, et al.; for WHO’s Global TB Programme. WHO’s new end TB strategy. Lancet. 2015;385:1799–801. DOIPubMedGoogle Scholar
- Dodd PJ, Yuen CM, Jayasooriya SM, van der Zalm MM, Seddon JA. Quantifying the global number of tuberculosis survivors: a modelling study. Lancet Infect Dis. 2021;21:984–92. DOIPubMedGoogle Scholar
- Miller TL, Wilson FA, Pang JW, Beavers S, Hoger S, Sharnprapai S, et al. Mortality hazard and survival after tuberculosis treatment. Am J Public Health. 2015;105:930–7. DOIPubMedGoogle Scholar
- Centers for Disease Control and Prevention, National Center for Health Statistics. National Death Index [cited 2024 Aug 1]. https://www.cdc.gov/nchs/ndi
- Georgia Department of Public Health. 2020 Georgia TB reference guide [cited 2024 Aug 1]. https://dph.georgia.gov/document/document/2020georgiatbreferenceguidepdf/download
- Nahid P, Mase SR, Migliori GB, Sotgiu G, Bothamley GH, Brozek JL, et al. Treatment of drug-resistant tuberculosis. An official ATS/CDC/ERS/IDSA clinical practice guideline. Am J Respir Crit Care Med. 2019;200:e93–142. DOIPubMedGoogle Scholar
- Nahid P, Dorman SE, Alipanah N, Barry PM, Brozek JL, Cattamanchi A, et al. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis. Clin Infect Dis. 2016;63:e147–95. DOIPubMedGoogle Scholar
- Georgia Department of Public Health. State electronic notifiable disease surveillance system [cited 2024 Oct 4]. https://sendss.state.ga.us
- Georgia Department of Public Health. Online analytical statistical information system [cited 2024 Oct 4]. https://oasis.state.ga.us
- Georgia Department of Public Health. Diabetes [cited 2024 Jan 5]. https://dph.georgia.gov/chronic-disease-prevention/diabetes
- Centers for Disease Control and Prevention. BRFSS prevalence and trends data, alcohol consumption, heavy drinking, 2014 [cited 2023 Jan 5]. https://nccd.cdc.gov/BRFSSPrevalence/rdPage.aspx
- Georgia Department of Public Health. Georgia HIV surveillance data [cited 2024 Aug 2]. https://dph.georgia.gov/epidemiology/georgias-hivaids-epidemiology-section/georgia-hiv-surveillance-data
- US Department of Housing and Urban Development, Office of Policy Development and Research. 2014 AHAR: Part 1—PIT estimates of homelessness in the US [cited 2024 Aug 2]. https://www.huduser.gov/portal/datasets/ahar/2014-ahar-part-1-pit-estimates-of-homelessness.html
- World Population Review. Immigrants by state 2024 [cited 2024 Jan 5]. https://worldpopulationreview.com/state-rankings/immigrants-by-state
- Akaike H. A new look at the statistical model identification. IEEE Trans Automat Contr. 1974;19:716–23. DOIGoogle Scholar
- Klein RJ, Schoenborn CA. Centers for Disease Control and Prevention. Age adjustment using the 2000 projected U.S. population. Statistical notes, January 2001 [cited 2024 Oct 4]. https://www.cdc.gov/nchs/data/statnt/statnt20.pdf
- US Department of Commerce, Bureau of the Census. Population projections of the United States by age, sex, race, and Hispanic origin: 1995 to 2050 [cited 2024 Aug 1]. https://www.census.gov/content/dam/Census/library/publications/1996/demo/p25-1130.pdf
- von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4:
e296 . DOIPubMedGoogle Scholar - Park SC, Kang MJ, Han CH, Lee SM, Kim CJ, Lee JM, et al. Long-term mortality of patients with tuberculosis in Korea. Int J Tuberc Lung Dis. 2020;24:492–8. DOIPubMedGoogle Scholar
- Choi H, Han K, Jung J-H, Park SH, Kim SH, Kang HK, et al. Long-term mortality of tuberculosis survivors in Korea: a population-based longitudinal study. Clin Infect Dis. 2023;76:e973–81. DOIPubMedGoogle Scholar
- Joseph Y, Yao Z, Dua A, Severe P, Collins SE, Bang H, et al. Long-term mortality after tuberculosis treatment among persons living with HIV in Haiti. J Int AIDS Soc. 2021;24:
e25721 . DOIPubMedGoogle Scholar - Dangisso MH, Woldesemayat EM, Datiko DG, Lindtjørn B. Long-term outcome of smear-positive tuberculosis patients after initiation and completion of treatment: A ten-year retrospective cohort study. PLoS One. 2018;13:
e0193396 . DOIPubMedGoogle Scholar - Liu Y, Zheng Y, Chen J, Shi Y, Shan LY, Wang S, et al. Tuberculosis-associated mortality and its risk factors in a district of Shanghai, China: a retrospective cohort study. Int J Tuberc Lung Dis. 2018;22:655–60. DOIPubMedGoogle Scholar
- Wang X-H, Ma A-G, Han X-X, Liang H, Wang D, Schouten E, et al. Survival and associated mortality risk factors among post-treatment pulmonary tubercolosis patients in the northwest of China. Eur Rev Med Pharmacol Sci. 2015;19:2016–25.PubMedGoogle Scholar
- Hendi AS, Ho JY. Immigration and improvements in American life expectancy. SSM Popul Health. 2021;15:
100914 . DOIPubMedGoogle Scholar - Miller EA, McCarty FA, Parker JD. Racial and ethnic differences in a linkage with the National Death Index. Ethn Dis. 2017;27:77–84. DOIPubMedGoogle Scholar
- Gray NA, Boucher NA, Cervantes L, Berlinger N, Smith SK, Johnson KS. Hospice access and scope of services for undocumented immigrants: a clinician survey. J Palliat Med. 2021;24:1167–73. DOIPubMedGoogle Scholar
- Lee-Rodriguez C, Wada PY, Hung Y-Y, Skarbinski J. Association of mortality and years of potential life lost with active tuberculosis in the United States. JAMA Netw Open. 2020;3:
e2014481 . DOIPubMedGoogle Scholar - Schechter MC, Bizune D, Kagei M, Holland DP, Del Rio C, Yamin A, et al. Challenges across the HIV care continuum for patients with HIV/TB co-infection in Atlanta, GA. Open Forum Infect Dis. 2018;5:
ofy063 . DOIPubMedGoogle Scholar - Johnston JC, Cooper R, Menzies D. Chapter 5: treatment of tuberculosis disease. Can J Respir Crit Care Sleep Med. 2022;6(sup1):66–76. DOIGoogle Scholar
- Tsang CA, Patel NN, Stout JE, Fernando R, Pratt R, Goswami ND. Factors associated with receiving longer than recommended therapy among culture-negative pulmonary tuberculosis patients. Open Forum Infect Dis. 2022;9:
ofac630 . DOIPubMedGoogle Scholar
1Current affiliation: University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Page created: September 12, 2024
Page updated: October 22, 2024
Page reviewed: October 22, 2024
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.