Factors Associated with Mortality AmongTuberculosis Patients In Nongkhai Hospital at Nongkhai Province Factors Associated with Mortality AmongTuberculosis Patients In Nongkhai Hospital at Nongkhai Province.

Abstract

          The objective of this study was identified factors associated with mortality among tuberculosis patients at Nongkhai hospital in Nongkhai province during the period from 1^st October 2020 to 30^th September 2022. Unmatched case-control was the design of this study Cases were 40 patients and died during tuberculosis treatment and controls were 120 patients and cured or completed treatment. Data was collected from hospital medical records. A univariate analysis using the simple logistic regression was performed to identify the factors associated with mortality among smear-positive TB patients. A multiple logistic regression analysis was then performed to compute adjusted odds ratios (ORadj) with 95% confidence intervals.

        The results showed that the significantly associated factors with mortality among smear-positive tuberculosis patients  those people aged 60 years and over have a 3.08 times higher mortality rate compared to people aged less than 60 years, with statistical significance   (OR_adj = 3.08; 95% CI = 1.03–9.21). Patients with no medication supervision had a 7.51 times higher mortality rate than patients with medication supervision and a lower BMI (OR_adj = 7.51; 95% CI = 2.88–19.57). Patients with a BMI of less than 20 had a 2.99 times higher mortality rate compared to those with a BMI of 20 or more (OR_adj = 2.99; 95% CI = 0.07-8.36). For people infected with HIV, there is a 9.89-times higher mortality rate compared to people who are not infected with HIV, with statistical significance (OR_adj = 9.89; 95% CI = 2.62–37.34). Patients with high blood pressure have a 3.61 times higher mortality rate compared to people without high blood pressure, with statistical significance (OR_adj = 3.61; 95% CI = 1.13–1.53). Patients with blood diseases have a 9.34 times higher mortality rate compared to people without blood diseases, with statistical significance (OR_adj = 9.34; 95% CI = 1.60-54.31).                     Therefore the system should be organized to assess the risk factors for death of individual TB patients from the beginning of treatment, and a joint care plan should be followed up between multidisciplinary teams, public health volunteers, community leaders, and local administrative organizations. In addition, there should be a screening for tuberculosis in high-risk groups to quickly take the patients into the treatment system and reduce mortality.