ArticleBMC infectious diseases2018
Mortality and associated factors of patients with extensive drug-resistant tuberculosis: an emerging public health crisis in China.
Article in BMC infectious diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Environmental health recommendations for Multidrug-Resistant Tuberculosis in low- and middle-income countries: a systematic review.BMC public health · 2026Pooled it
- Predictors of mortality in patients with drug-resistant tuberculosis: A systematic review and meta-analysis.PloS one · 2021Pooled it
- Tuberculosis disease characteristics associated with mortality, severe morbidity and unsuccessful treatment in people living with HIV treated for tuberculosis - a secondary analysis of the ANRS 12300 Reflate TB2 trial.BMC infectious diseases · 2025Trial
- Strengthening Clinical Governance and Public Health Interventions to Improve Drug-Resistant Tuberculosis Outcomes in Rural South Africa.Healthcare (Basel, Switzerland) · 2025Article
- Mortality rate and associated factors among patients co-infected with drug resistant tuberculosis/HIV at Mulago National Referral Hospital, Uganda, a retrospective cohort study.PLOS global public health · 2023Article
- Low BMI increases all-cause mortality rates in patients with drug-resistant TB.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022Article
- Risk Factors for Poor Outcomes Among Patients with Extensively Drug-Resistant Tuberculosis (XDR-TB): A Scoping Review.Infection and drug resistance · 2021Article
- Malnutrition prevalence and associated biochemical factors among drug-resistance tuberculosis (DR-TB) patients at key treatment sites in Conakry City, Republic of Guinea.The Pan African medical journal · 2021Article
- Combining interferon-The Journal of international medical research · 2020Observational
- Associations of ambient air pollutants with regional pulmonary tuberculosis incidence in the central Chinese province of Hubei: a Bayesian spatial-temporal analysis.Environmental health : a global access science source · 2020Article
- Performance of Genotype MTBDRsl V2.0 over the Genotype MTBDRsl V1 for detection of second line drug resistance: An Indian perspective.PloS one · 2020Article
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Authors and funding
13 authors.
Funding
Abstract
backgroundLimited treatment options of extensive drug-resistant tuberculosis (XDR-TB) have led to its high mortality worldwide. Relevant data about mortality of XDR-TB patients in literature are limited and likely underestimate the real situation in China, since the majority of patients with XDR-TB are lost to follow-up after discharge from TB hospitals. In this study, we sought to investigate the mortality and associated risk factors of Human Immunodeficiency Virus (HIV)-negative patients with XDR-TB in China.
methodsAll patients who were diagnosed with XDR-TB for the first time in four TB care centers across China between March 2013 and February 2015 were consecutively enrolled. Active tracking through contacting patients or family members by phone or home visit was conducted to obtain patients' survival information by February 2017. Multivariable Cox regression models were used to evaluate factors associated with mortality.
resultsAmong 67 patients enrolled, the mean age was 48.7 (Standard Deviation [SD] = 16.7) years, and 51 (76%) were men. Fourteen patients (21%) were treatment naïve at diagnosis indicating primary transmission. 58 (86.8%) patients remained positive for sputum smear or culture when discharged. During a median follow-up period of 32 months, 20 deaths occurred, with an overall mortality of 128 per 1000 person-years. Among patients who were dead, the median survival was 5.4 months (interquartile range [IQR]: 2.2-17.8). Seventeen (85%) of them died at home, among whom the median interval from discharge to death was 8.4 months (IQR: 2.0-18.2). In Cox proportional hazards regression models, body mass index (BMI) < 18.5 kg/m
conclusionOur study suggested an alarming situation of XDR-TB patients in China with a sizable proportion of newly transmitted cases, a high mortality rate, and a long period in community. This observation calls for urgent actions to improve XDR-TB case management in China, including providing regimens with high chances of cure and palliative care, and enhanced infection control measures.
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