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East African Medical Journal

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A retrospective review of mortality among TB patients in Kwale County, 2012‐2016

L Tanui, A.B. Kihara, J Karumbi, M.K. Kilonzo, D Ondieki, G Gwako, K Everlyn, C.M. Mwacha‐Kwasa, Enos Masini, Hajara El‐Busaidy, M Kamene, E Omesa

Abstract


Background: Tuberculosis (TB) is the leading cause of mortality among infectious diseases globally, surpassing HIV. There were 1.5 million deaths attributed to TB in 2014, and 0.4 million of these were TB‐HIV co‐infected. The World Health Organization End TB strategy focuses on 95% reduction of mortality from Tuberculosis by 2035. The mortality rate of all TB in Kenya is 7%. There is limited information on the characteristics of patients dying after being diagnosed with TB in Kenya.

Objective: To determine the characteristics of patients who died while on management for TB in Kwale County in the period 2012‐2016.

Design: A retrospective cross‐sectional study

Setting: Kwale County, Kenya

Results: We reviewed mortality records of 330 out of 5957 cases notified between 2012 and 2016 giving a mortality rate of 6%.The males accounted for 180(54.5%) with the adults aged above 45 years comprising of 20% of all cases. Smear negative presentation was found among 141(42.7%), with 258 (78.2%) with pulmonary TB. The moderately malnourished accounted for 109(40.0%). The HIV negative accounted for 158 (48%) of all cases and 283 (86%) among new cases. Of the HIV positive patients, 109(73.0%) had been initiated on ART. There were 172 (52.1%) of deaths that occurred after 60 days of initiation of TB treatment.

Conclusion: We observed a high all‐cause mortality rate among patients with tuberculosis in Kwale County. They were clinically characterized new patients, were HIV negative, majority of patients well‐nourished and death occurred after intensive phase of Tuberculosis treatment. There is need to consider other diagnosis among patients with these characteristics in the population. We recommend a follow‐up study to determine predictors of death and review of National data.




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