Secondary Data Analysis of Tuberculosis Deaths in Bulawayo Province, Zimbabwe, 2016-2019

Abstract

Background: Tuberculosis is a leading cause of death globally, and the third leading cause of death in Zimbabwe. Death from any cause following a diagnosis of tuberculosis is classified as a tuberculosis death. Bulawayo Province reported high tuberculosis death rates from 15.3% in 2016 to 14.2% in 2019 against a threshold of 5%. We analyzed tuberculosis deaths for Bulawayo Province to characterize patients dying and to make recommendations for improving treatment outcomes for susceptible tuberculosis cases. Methods: A descriptive cross-sectional study was conducted. We analyzed all (N = 469) records of tuberculosis deaths from 19/19 Bulawayo tuberculosis diagnosing centers from 01 January 2016 to 31 December 2019. Microsoft ® Excel 2007 was used to generate graphs and Stata ® version 17 was used to conduct chi-square tests for trends. Results: Males accounted for 278/469 (59.3%) of the deaths. The median age of death was 40 years (Q 1 = 33: Q 3 = 51). The proportion of TB deaths increased from 63/114 (55%) in 2016 to 57/90 (63%) in 2019 for males (p < 0.01). The majority of deaths 278/469 (59.3%) occurred in the intensive phase of treatment and anemia was a co-morbid condition in only 44/469 (9.4%) of the tuberculosis deaths. Testing for anemia was not routinely done. Conclusion: High death rates particularly in the intensive phase, could be attributed to sub-optimal clinical care. Tuberculosis programs should work towards adopting differentiated care models for tuberculosis patients and developing algorithms for patients at high risk of death.