ArticleScientific reports2025
Incidence and predictors of mortality among persons with rifampicin-resistant tuberculosis and HIV in Mozambique.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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5 authors.
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Abstract
Rifampicin-Resistant Tuberculosis (RRTB) is associated with a high risk of mortality during treatment. This study aims to describe the baseline characteristics associated with incidence of mortality in persons with rifampicin-resistant tuberculosis (P-RRTB) in a rural setting in Mozambique. We analyzed cohort data collected retrospectively from paper medical files and electronic medical records of P-RRTB who were routinely treated at Carmelo Hospital of Chokwe (Gaza province, Mozambique), from 1st January 2015 to 31st December 2020. Kaplan-Meier survival curves and adjusted Cox regression analyses were used to model the time to death and associated factors of mortality. Overall, 151 P-RRTB contributed to a total number of 1812 person-months (PM) of treatment follow-up. The overall mortality rate was 1.9 per 100 person-months (95% confidence interval [CI]: 1.3-2.1). Adjusted Cox regression predicted higher risk of mortality in those treated with injectable anti-RRTB second line drugs (SLD), (adjusted hazard ratio [aHR] 3.72, 95% CI 1.23-11.22, p = 0.020), had a parenchymal lesion with more than 50% fibrosis (aHR 3.06, 95% CI 1.38-6.79, p = 0.006), presented right ventricular dysfunction on the echocardiogram with venous assessment (aHR 3.18, 95% CI 1.15-8.83, p = 0.026), and manifested baseline hemoglobin (Hgb) = 8.0-9.9 g/dL (aHR 2.82, 95% CI 1.09-7.27, p = 0.032), as well Hgb < 7.9 g/dL (aHR 3.06, 95%CI 1.24-7 0.51, p = 0.015). However, lower risk of mortality was predicted in those who had an optimal immunovirological response to ART (aHR 0.18, 95% CI 0.04-0.93, p = 0.040). Kaplan-Meier analysis showed higher cumulative incidence of mortality after 3 months of follow-up, above 26% in those with immunovirological failure to ART therapy (p = 0.006), 45% with Hgb < 7.9 g/dL (p < 0.001), 23% in treated with injectables-based drugs (p = 0.03), 39% with parenchymal lesion > 50% fibrosis on the chest X-ray (p < 0.001), 56% with right ventricular dysfunction (p = 0.003). Mortality risk among P-RRTB was higher in those with anemia, injectable anti-RRTB medications, lung lesions > 50% fibrosis, and right ventricular dysfunction.
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