Population Differences in Death Rates in HIV-Positive Patients with Tuberculosis.

Hdl Handle:
http://hdl.handle.net/10144/20673
Title:
Population Differences in Death Rates in HIV-Positive Patients with Tuberculosis.
Authors:
Ciglenecki, I; Glynn, J R; Mwinga, A; Ngwira, B; Zumla, A; Fine, P E M; Nunn, A
Journal:
International Journal of Tuberculosis and Lung Disease
Abstract:
SETTING: Randomised controlled clinical trial of Mycobacterium vaccae vaccination as an adjunct to anti-tuberculosis treatment in human immunodeficiency virus (HIV) positive patients with smear-positive tuberculosis (TB) in Lusaka, Zambia, and Karonga, Malawi. OBJECTIVE: To explain the difference in mortality between the two trial sites and to identify risk factors for death among HIV-positive patients with TB. DESIGN: Information on demographic, clinical, laboratory and radiographic characteristics was collected. Patients in Lusaka (667) and in Karonga (84) were followed up for an average of 1.56 years. Cox proportional hazard analyses were used to assess differences in survival between the two sites and to determine risk factors associated with mortality during and after anti-tuberculosis treatment. RESULTS: The case fatality rate was 14.7% in Lusaka and 21.4% in Karonga. The hazard ratio for death comparing Karonga to Lusaka was 1.47 (95% confidence interval [CI] 0.9-2.4) during treatment and 1.76 (95%CI 1.0-3.0) after treatment. This difference could be almost entirely explained by age and more advanced HIV disease among patients in Karonga. CONCLUSION: It is important to understand the reasons for population differences in mortality among patients with TB and HIV and to maximise efforts to reduce mortality.
Affiliation:
Médecins Sans Frontières, Geneva, Switzerland. iza_ciglenecki@yahoo.com
Publisher:
International Union Against TB and Lung Disease
Issue Date:
Oct-2007
URI:
http://hdl.handle.net/10144/20673
PubMed ID:
17945070
Additional Links:
http://www.ingentaconnect.com/content/iuatld/ijtld
Language:
en
ISSN:
1027-3719
Appears in Collections:
TB; HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorCiglenecki, I-
dc.contributor.authorGlynn, J R-
dc.contributor.authorMwinga, A-
dc.contributor.authorNgwira, B-
dc.contributor.authorZumla, A-
dc.contributor.authorFine, P E M-
dc.contributor.authorNunn, A-
dc.date.accessioned2008-03-14T08:54:15Z-
dc.date.available2008-03-14T08:54:15Z-
dc.date.issued2007-10-
dc.identifier.citationPopulation Differences in Death Rates in HIV-Positive Patients with Tuberculosis. 2007, 11 (10):1121-8 Int. J. Tuberc. Lung Dis.en
dc.identifier.issn1027-3719-
dc.identifier.pmid17945070-
dc.identifier.urihttp://hdl.handle.net/10144/20673-
dc.description.abstractSETTING: Randomised controlled clinical trial of Mycobacterium vaccae vaccination as an adjunct to anti-tuberculosis treatment in human immunodeficiency virus (HIV) positive patients with smear-positive tuberculosis (TB) in Lusaka, Zambia, and Karonga, Malawi. OBJECTIVE: To explain the difference in mortality between the two trial sites and to identify risk factors for death among HIV-positive patients with TB. DESIGN: Information on demographic, clinical, laboratory and radiographic characteristics was collected. Patients in Lusaka (667) and in Karonga (84) were followed up for an average of 1.56 years. Cox proportional hazard analyses were used to assess differences in survival between the two sites and to determine risk factors associated with mortality during and after anti-tuberculosis treatment. RESULTS: The case fatality rate was 14.7% in Lusaka and 21.4% in Karonga. The hazard ratio for death comparing Karonga to Lusaka was 1.47 (95% confidence interval [CI] 0.9-2.4) during treatment and 1.76 (95%CI 1.0-3.0) after treatment. This difference could be almost entirely explained by age and more advanced HIV disease among patients in Karonga. CONCLUSION: It is important to understand the reasons for population differences in mortality among patients with TB and HIV and to maximise efforts to reduce mortality.en
dc.language.isoenen
dc.publisherInternational Union Against TB and Lung Diseaseen
dc.relation.urlhttp://www.ingentaconnect.com/content/iuatld/ijtlden
dc.rightsArchived on this site with the kind permission of the International Union Against TB and Lung Disease, http://www.iuatld.orgen
dc.subject.meshAdulten
dc.subject.meshBacterial Vaccinesen
dc.subject.meshCause of Deathen
dc.subject.meshDouble-Blind Methoden
dc.subject.meshFemaleen
dc.subject.meshHIV Seropositivityen
dc.subject.meshHumansen
dc.subject.meshMaleen
dc.subject.meshMiddle Ageden
dc.subject.meshMultivariate Analysisen
dc.subject.meshMycobacterium tuberculosisen
dc.subject.meshPrognosisen
dc.subject.meshRisk Factorsen
dc.subject.meshSex Distributionen
dc.subject.meshSurvival Rateen
dc.subject.meshTreatment Outcomeen
dc.subject.meshTuberculosis, Pulmonaryen
dc.subject.meshVaccinationen
dc.subject.meshZambiaen
dc.titlePopulation Differences in Death Rates in HIV-Positive Patients with Tuberculosis.en
dc.contributor.departmentMédecins Sans Frontières, Geneva, Switzerland. iza_ciglenecki@yahoo.comen
dc.identifier.journalInternational Journal of Tuberculosis and Lung Diseaseen

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