Submission ID 118246
| Issue/Objective | TB and HIV are still public health problems in low- and middle-income countries, including Rwanda. Despite the decreasing burden of these two diseases, they still make a significant contribution to mortality. Rwanda is among the 30 high TB and HIV burdens. This study assessed mortality rate, survival probability, and factors associated with death among pediatric and adult patients on TB treatment in Rwanda. |
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| Methodology/Approach | A secondary analysis of Tuberculosis routine data was conducted in six districts of Rwanda. We utilized case-based TB program data of both adults (≥15 years) and pediatric (<15 years) enrolled in TB treatment between December 2017 to December 2022 and followed them for six (6) months. Survival probabilities were determined using the Kaplan-Meier estimator, and a cox proportional hazard model was used to assess independent risk factors of TB mortality. |
| Results | A total of 65,535 patients confirmed with tuberculosis were enrolled in anti-TB treatment. Of these, 6115 (9.3%) missed outcome status, and 227 (0.3%) were lost to follow-up. Fifty-nine, one hundred ninety-three (59,193 (90.3%) patients with complete outcome status were analyzed. The overall mean age was 40.6, standard deviation (SD)=21. During the follow-up period, 2307 patients died, making an overall incidence density rate (IDR) of 3.4 per 1000 person-months. The independent risk factors of TB mortality were patients with HIV and TB (adjusted hazard ratio (aHR)= 2.2, 95% confidence interval (CI) =1.8-2.7), being male aHR= 1.2, 95%CI = 1.1-1.3, receiving services at Hospital aHR =1.8, 95%CI=1.6-1.9 and Health Center aHR = 1.3. 95%CI =1.3-1.8, clients with history of relapses aHR = 1.3, 95%CI=1.0-1.8, Patients with extra pulmonary TB aHR = 1.4, 95%CI=1.3-1.5 and home-based direct therapy aHR = 5.4, 95%CI= 4.3-6.7 |
| Discussion/Conclusion | The study demonstrated an overall incidence density of 3.4 per 1000 person-months. Patients with HIV co-infection, admitted at Hospital and health Centers, with history of TB relapse, having history of extra-pulmonary TB, and at home-based treatment options were more likely to die than their counterparts. |
| Presenters and affiliations | uwase Nkusi Diana society for Family Health (SFH), Kigali, Rwanda Munana Steven King Faisal Hospital Rwanda Foundation and Africa health sciences university Absolomon GASHAIJA Centre for Impact, Innovation and Capacity building for Health Information Systems and Nutrition (CIIC-HIN), Kigali, Rwanda |
