TB death surveillance and response (TBDSR) - A step towards zero deaths due to TB. Lessons learnt from West Bengal, India

IF 2.3 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2025-06-16 DOI:10.1016/j.cegh.2025.102106

Abhijit Dey , Santosh Kumar Roy , Poulami Basu , Dhrubajyoti Deka , Rajat Basu , Simran Keshri , Bandita Sengupta , Sandip Roy

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引用次数: 0

Abstract

Background

West Bengal, an eastern state of India, has introduced a tuberculosis (TB) death review system called TB Death Surveillance and Response (TBDSR). The State has developed a dedicated web portal for TB death information management. This study assessed the preventable factors associated with the death of a person with TB (PwTB)

Methods

This is a mixed-method observational study. In 2023, a total of 5332 PwTB died due to any reason before completion of treatment. This was the study population. A secondary analysis was done on the routinely collected data from the TBDSR portal.

Results

The odds of death were significantly & independently higher among the elderly, males, severely underweight, extra-pulmonary TB, drug-resistant TB, HIV + ve, diabetics, and those who are not initiated with anti-TB drugs.

The median time of death was 30 days after TB diagnosis. 10 % died before treatment initiation, 46 % died within one month, 19 % died between 1 and 2 months.79 % died at home and 2 % during transit.

The major underlying causes of death were TB (40 %), Cerebrovascular accident (22 %), and old age (17 %).

Contributors of deaths were delay in care seeking, self-perceived stigma, comorbidities, and unavailability of hospital admission facilities/transport facilities/critical care setup for PwTBs.

Conclusion

West Bengal has a well-designed system of TB death surveillance. The TBDSR model can be replicated in other high-burden areas. The majority of the PwTBs are dying at home within two months of TB diagnosis. The findings of TBDSR warrant several critical steps for the reduction of mortality due to preventable reasons.

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结核病死亡监测和应对（TBDSR）——朝着结核病零死亡迈出的一步。从印度西孟加拉邦吸取的教训

背景：印度东部的西孟加拉邦引入了一种称为结核病死亡监测和反应（TBDSR）的结核病死亡审查系统。国家开发了一个专门用于结核病死亡信息管理的门户网站。本研究评估了与结核病患者死亡相关的可预防因素。方法：这是一项混合方法观察性研究。2023年，共有5332名PwTB患者在治疗完成前因任何原因死亡。这是研究人群。对从TBDSR门户网站常规收集的数据进行了二次分析。结果两组患者的死亡几率有显著性差异；在老年人、男性、严重体重不足、肺外结核、耐药结核、HIV + ve、糖尿病患者和未开始使用抗结核药物的人群中独立较高。中位死亡时间为结核诊断后30天。10%在开始治疗前死亡，46%在1个月内死亡，19%在1至2个月内死亡。79%死于家中，2%死于运输途中。主要的潜在死亡原因是结核病（40%）、脑血管意外（22%）和老年（17%）。造成死亡的因素包括求医延误、自我感觉耻辱、合并症以及无法获得收治设施/运输设施/残疾结核病重症监护设施。结论西孟加拉邦具有设计完善的结核病死亡监测系统。TBDSR模式可在其他高负担地区复制。大多数pwtb患者在诊断出结核病后的两个月内在家中死亡。TBDSR的调查结果为减少可预防原因造成的死亡率提供了若干关键步骤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.