A high tuberculosis case-fatality rate in a setting of effective tuberculosis control: Implications for acceptable treatment success rates

J. F. Fielder, C. P. Chaulk, M. Dalvi, R. Gachuhi, G. W. Comstock, T. R. Sterling

Research output: Contribution to journalArticle

Abstract

Worldwide, the case-fatality rate of smear-positive pulmonary tuberculosis among persons on treatment is 3.8%. We assessed the case-fatality rate among such patients in Baltimore between January 1993 and June 1998. Tuberculosis incidence was <17/100 000 population, and 99% of patients received directly observed therapy. Of 174 patients, 42 (24%) died on treatment. Patients who died were older (mean age 62 vs. 47 years; P < 0.001) and were more likely to have underlying medical conditions. In multivariate analyses, older age, diabetes mellitus, and renal failure were independently associated with an increased risk of death. With effective control, tuberculosis may become concentrated in older persons with chronic diseases and be associated with high case-fatality rates. In such settings, acceptable treatment success rates may need to be revised.

Original languageEnglish (US)
Pages (from-to)1114-1117
Number of pages4
JournalInternational Journal of Tuberculosis and Lung Disease
Volume6
Issue number12
StatePublished - Dec 1 2002

Keywords

  • Directly observed therapy
  • Mortality
  • Treatment of tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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