Factors Associated with Death among Tuberculosis Patients Followed at Ignace Deen Hospital in Conakry, Guinea
Camara Naby
*
Dabola Prefectural Health Department, Faranah Regional Health Inspectorate, Ministry of Health and Public Hygiene, Republic of Guinea.
Traore Fodé Amara
Institut National de Santé Publique, Ministry of Health and Public Hygiene, Republic of Guinea and Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University, Conakry, Republic of Guinea.
Camara Gbawa
Agence Nationale de Sécurité Sanitaire, Ministry of Health and Public Hygiene, Republic of Guinea.
Sylla Sékou Sidate
Dalaba Prefectural Health Department, Mamou Regional Health Inspectorate, Ministry of Health and Public Hygiene, Republic of Guinea.
Camara Lansana Mady
Faculty of Health Sciences and Techniques, Gamal Abdel Nasser University, Conakry, Republic of Guinea and Ignace Deen National Hospital, Ministry of Health and Public Hygiene, Republic of Guinea.
Méda Nicola
Coordination of the Burkina Faso, Epidemiology and Field Laboratory, Training Programme (BFELTP) Joseph KI-ZERBO University, Burkina Faso.
Yanogo Pauline
Coordination of the Burkina Faso, Epidemiology and Field Laboratory, Training Programme (BFELTP) Joseph KI-ZERBO University, Burkina Faso.
Kéïta Sakoba
Agence Nationale de Sécurité Sanitaire, Ministry of Health and Public Hygiene, Republic of Guinea.
Camara Aly
Agence Nationale de Sécurité Sanitaire, Ministry of Health and Public Hygiene, Republic of Guinea and Programme Elargie de Vaccination, Ministry of Health and Public Hygiene, Republic of Guinea.
Diare Abou
Agence Nationale de Sécurité Sanitaire, Ministry of Health and Public Hygiene, Republic of Guinea.
Kourouma ML
Agence Nationale de Sécurité Sanitaire, Ministry of Health and Public Hygiene, Republic of Guinea.
Keita Ibrahima
Institut National de Santé Publique, Ministry of Health and Public Hygiene, Republic of Guinea.
Doukouré Sékou Manamaï
Institut National de Santé Publique, Ministry of Health and Public Hygiene, Republic of Guinea.
Gakou Fatoumata
Institut National de Santé Publique, Ministry of Health and Public Hygiene, Republic of Guinea.
Barry Mamadou Billo Aye
Dabola Prefectural Health Department, Faranah Regional Health Inspectorate, Ministry of Health and Public Hygiene, Republic of Guinea.
*Author to whom correspondence should be addressed.
Abstract
Introduction: In many countries, large numbers of tuberculosis patients continue to die despite the efforts of control programmes. The aim of this study was to identify the factors associated with death in patients.
Material and Methods: This was a retrospective cohort study using routine data from the respiratory medicine department of Ignace Deen Hospital in Conakry (Guinea) over a 6-year period (from 1 January 2015 to 31 December 2020). A multivariate analysis using the Cox model was used to identify the factors associated with death, using R software. The significance level was set at 0.05 for the final model.
Results: During the study period, 1,579 patients with tuberculosis were seen in the department, of whom 618 were included. The median age was 39, with extremes of 28 and 51. There was a predominance of men (69.90%). The majority marital status was single (71.52%). The main clinical signs were cough (87.38%), chest pain (66.99%) and night sweats (77.35%). Paraclinically, bacilloscopy was positive in 79.77% of cases. The mortality rate was 10%. In multivariate analysis, the factors independently associated with the occurrence of death in patients with tuberculosis were body mass index < 17.5 kg/m2 (adjusted RR = 4.32 [2.28-8.17] ; adjusted p-value < 0.0001); chronic obstructive pulmonary disease (adjusted RR = 10.83 [5.01-23.41]; adjusted p-value < 0.0001); diabetes (adjusted RR = 9.41 [3.63-24.41]; adjusted p-value < 0.0001) and HIV status (RR = 2.67 [1.42-5.03]; adjusted p-value = 0.00229).
Conclusion: These results underline the need to strengthen the overall management of tuberculosis patients, particularly those with identified risk factors, by stepping up efforts in the areas of early detection, nutritional support and management of co-morbidities.
Keywords: Tuberculosis, factors, deaths, hospital, Guinea