Time-to-event analysis of factors influencing mortality among pediatric patients receiving drug-susceptible tuberculosis treatment

IF 1.9 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2026-09-01 Epub Date: 2026-08-29 DOI:10.1016/j.cegh.2026.102458

Shalini Kumari, Subhajit Das, Alok Kumar, Jai Krishna Mishra, Brajesh Kumar Rai, Mukesh Kumar

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引用次数: 0

Abstract

Background:

Tuberculosis (TB) remains a global public health challenge affecting all age groups. Children and adolescents are most vulnerable group that contribute to the overall TB burden. This study examined the epidemiological characteristics and factors associated with mortality among pediatric patients received Drug Suceptible (DS) TB treatment.

Methods:

This retrospective study analyzed data from 2300 pediatric TB patients registered for treatment in the Nikshay portal at the Department of TB and Respiratory Diseases, Sir Sunder Lal Hospital, Banaras Hindu University, Varanasi, India, between January 2017 and December 2023. Survival patterns were evaluated using the Kaplan–Meier estimates, Cox regression, and accelerated failure time (AFT) models with Weibull, log–logistic, and log-normal distributions. Model performance was assessed using Cox–Snell residual plots, log-likelihood, AIC, and BIC values.

Results:

Out of the 2300 pediatric TB patients included, 92 (4.0%) died during treatment. The log-normal AFT model provided the best fit and showed that Age (

β = 0.228

p < 0.001

) and Site of disease (pulmonary TB) (

β = 1.375

p < 0.001

) were associated with longer survival time. Whereas, microbiologically confirmed TB patients (

β = - 2.255

p < 0.001

) were associated with accelerated time to death. Kaplan–Meier analysis also showed higher mortality in children aged 1–6 years, patients with microbiologically confirmed TB, those with extrapulmonary disease, and patients whose follow-up was not done.

Conclusions:

Pediatric patients with these predictors represent high-risk groups requiring closer monitoring and targeted clinical management. Early identification and timely treatment of severe TB cases may improve survival outcomes and support progress toward TB elimination goals.

查看原文本刊更多论文

对接受药物敏感结核治疗的儿童患者死亡率影响因素的时间-事件分析

背景：结核病（TB）仍然是影响所有年龄组的全球公共卫生挑战。儿童和青少年是造成结核病总体负担的最脆弱群体。本研究调查了接受药物易感性（DS）结核病治疗的儿科患者的流行病学特征和与死亡率相关的因素。方法：本回顾性研究分析了2017年1月至2023年12月期间在印度瓦拉纳西巴纳拉斯印度教大学Sir Sunder Lal医院结核病和呼吸道疾病科Nikshay门户网站登记治疗的2300名儿童结核病患者的数据。生存模式评估使用Kaplan-Meier估计，Cox回归，加速失效时间（AFT）模型与威布尔，对数逻辑和对数正态分布。使用Cox-Snell残差图、对数似然、AIC和BIC值评估模型性能。结果：在纳入的2300例儿童结核病患者中，92例（4.0%）在治疗期间死亡。对数正态AFT模型拟合最佳，显示年龄（β=0.228, p<0.001）和疾病部位（肺结核）（β=1.375, p<0.001）与较长的生存时间相关。然而，微生物学证实的结核病患者（β= - 2.255, p<0.001）与死亡时间加快相关。Kaplan-Meier分析还显示，1-6岁儿童、微生物学证实的结核病患者、肺外疾病患者和未进行随访的患者的死亡率较高。结论：具有这些预测因子的儿科患者是需要密切监测和有针对性的临床管理的高危人群。早期发现和及时治疗严重结核病病例可以改善生存结果，并支持朝着消除结核病目标取得进展。

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.