Determinants of tuberculosis mortality in an urban residents: A hospital-based cohort study in China

Abstract

Background and objectives

To reach the goal of a 95 % reduction in Tuberculosis (TB) mortality by 2035 compared to 2015, it may be necessary for different regions to create specific intervention strategies tailored to their respective TB mortality components. This study aimed to investigate the causes of death among TB patients in China's developed cities.

Methods

This retrospective cohort study included 8851TB patients registered at Shenzhen's largest TB-designated hospital between 2017 and 2022. The primary causes of death were categorized, and multivariable logistic regression was used to identify independent risk factors for TB mortality.

Results

The study revealed a TB mortality rate of 1.6 % during the treatment period. Independent risk factors for TB mortality included male gender, older age, lower body mass index (BMI), anemia, and the presence of tumors. Notably, poor treatment adherence was significant contributors to mortality, even in this well-resourced urban environment. Additionally, the progression of the chronic disease emerged as a critical factor in TB-related deaths, particularly among patients with severe underlying conditions.

Conclusion

This study underscores the importance of addressing treatment adherence and healthcare accessibility to reduce TB mortality, even in urban settings with robust healthcare infrastructure. The findings also highlight the need for integrated management of TB and chronic diseases, as well as early identification and management of underlying disease to improve patient outcomes. These insights are crucial for developing targeted interventions that can enhance TB care and reduce mortality in similar urban populations.