Mortality during tuberculosis treatment in South Africa using an 8-year analysis of the national tuberculosis treatment register

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dc.contributor.authorOsman, Muhammaden_ZA
dc.contributor.authorVan Schalkwyk, Carien_ZA
dc.contributor.authorNaidoo, Prenen_ZA
dc.contributor.authorSeddon, James A.en_ZA
dc.contributor.authorDunbare, Roryen_ZA
dc.contributor.authorDlamini, Sicelo S.en_ZA
dc.contributor.authorWelte, Alexen_ZA
dc.contributor.authorHesseling, Anneke C.en_ZA
dc.contributor.authorClaassens, Mareli M.en_ZA
dc.date.accessioned2023-04-06T07:54:54Zen_ZA
dc.date.available2023-04-06T07:54:54Zen_ZA
dc.date.issued2021-08en_ZA
dc.descriptionCITATION: Osman, M. et al. 2021. Mortality during tuberculosis treatment in South Africa using an 8-year analysis of the national tuberculosis treatment register. Scientific Reports, 11:15894, doi:10.1038/s41598-021-95331-w.en_ZA
dc.descriptionThe original publication is available at https://www.nature.comen_ZA
dc.description.abstractIn 2011, the South African HIV treatment eligibility criteria were expanded to allow all tuberculosis (TB) patients lifelong ART. The impact of this change on TB mortality in South Africa is not known. We evaluated mortality in all adults (≥ 15 years old) treated for drug-susceptible TB in South Africa between 2009 and 2016. Using a Cox regression model, we quantified risk factors for mortality during TB treatment and present standardised mortality ratios (SMR) stratified by year, age, sex, and HIV status. During the study period, 8.6% (219,618/2,551,058) of adults on TB treatment died. Older age, male sex, previous TB treatment and HIV infection (with or without the use of ART) were associated with increased hazard of mortality. There was a 19% reduction in hazard of mortality amongst all TB patients between 2009 and 2016 (adjusted hazard ratio: 0.81 95%CI 0.80–0.83). The highest SMR was in 15–24-year-old women, more than double that of men (42.3 in 2016). Between 2009 and 2016, the SMR for HIV-positive TB patients increased, from 9.0 to 19.6 in women, and 7.0 to 10.6 in men. In South Africa, case fatality during TB treatment is decreasing and further interventions to address specific risk factors for TB mortality are required. Young women (15–24-year-olds) with TB experience a disproportionate burden of mortality and interventions targeting this age-group are needed.en_ZA
dc.description.urihttps://www.nature.com/articles/s41598-021-95331-wen_ZA
dc.description.versionPublisher's versionen_ZA
dc.format.extent10 pagesen_ZA
dc.identifier.citationOsman, M. et al. 2021. Mortality during tuberculosis treatment in South Africa using an 8-year analysis of the national tuberculosis treatment register. Scientific Reports, 11:15894, doi:10.1038/s41598-021-95331-w.en_ZA
dc.identifier.issn2045-2322 (online)en_ZA
dc.identifier.otherdoi:10.1038/s41598-021-95331-wen_ZA
dc.identifier.urihttp://hdl.handle.net/10019.1/126774en_ZA
dc.language.isoen_ZAen_ZA
dc.publisherNatureen_ZA
dc.rights.holderAuthors retain copyrighten_ZA
dc.subjectTuberculosis -- Treatment -- South Africaen_ZA
dc.subjectCommunicable diseases -- South Africaen_ZA
dc.subjectTuberculosis -- Mortality -- South Africaen_ZA
dc.titleMortality during tuberculosis treatment in South Africa using an 8-year analysis of the national tuberculosis treatment registeren_ZA
dc.typeArticleen_ZA
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