Survival Analysis: An Application To Patients With Tuberculosis Infection (original) (raw)
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Evaluation of Some Factors Influencing Tuberculosis Patients: A Survival Analysis
Survival time analysis is the analysis of time to event. It is particularly used to identify risks involved in the survival data. A special type of data has to be analyzed with special methods. When survival times are analyzed without the use of special techniques, and if underlying assumptions were not taken into an account, then faulty interpretation would result. Tuberculosis (TB) is an infectious disease which has been persistent with humans throughout known history. The aim of this study is to establish the influence of socioeconomic, demographic as well as the environmental variables on tuberculosis patients in Nigeria. Non parametric (Kaplan Meire) and semi parametric (Cox proportional hazard) methods in Survival analysis were used in analyzing the data.Hazard ratio of different variables was determined using cox proportional hazard regression.Resultobtained by the PHreg procedure indicated tuberculosis category gender and age of patients as factors influencing tuberculosis patient. In this study we concluded that the accepted yearto-treatment hazard ratio for distinct concentrations in relation to the reference risk (year 2018) is 1.147, 0.669, 0.912 for years 2015, 2016, 2017 respectively. This means that patients admitted in 2018 have a brief survival time (i.e. will die more quickly from TB) relative to the baseline hazard (year 2018), and patients admitted for therapy in 2016 and 2017 also have a lower risk and survive longer than the baseline hazard. It has been noted, however, that year does not make a significant contribution to the model.
Introduction. Tuberculosis (TB) is a chronic infectious disease and mainly caused by mycobacterium tuberculosis (MTB). It has been one of the major causes of mortality in Ethiopia. The objective of the study was to identify factors that affect the survival of the patients with tuberculosis who started treatment for tuberculosis. Methods. This was a retrospective study in six randomly selected health centres in Addis Ababa, Ethiopia. The data were obtained from medical records of TB patients registered from September 2012 to August 2013 and treated under directly observed treatment surgery (DOTS) strategy. Kaplan Meier plots, logrank tests, and Wilcoxon tests were used to assess the survival pattern. Cox proportional hazards model for multivariable analysis was discussed. Results. Out of the total 826 registered TB patients, 105 (12.71%) died during the study period and 712 (87.29%) were censored. Based on Kaplan Meier survival curves, logrank test, and Wilcoxon test, it was found that the patients had statistically significant differences in survival experience with respect to age, body weight at initiation of treatment, TB patient category, and HIV status. Multivariable Cox hazards regression analysis revealed that the covariates age, TB patient category, HIV, and age by HIV interaction were significant risk factors associated with death status in TB patients. Conclusion. Deaths of individuals with diseases especially HIV coinfected and nonnew TB cases were high. Therefore, this needs to strengthen the follow-up of patients with TB treatment from the day of anti-TB treatment initiation to completion days.
2016
Copyright © 2014 K. Tolosie and M. K. Sharma.This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in anymedium, provided the originalwork is properly cited. Introduction. Tuberculosis (TB) is a chronic infectious disease and mainly caused by mycobacterium tuberculosis (MTB). It has been one of the major causes of mortality in Ethiopia.The objective of the study was to identify factors that affect the survival of the patients with tuberculosis who started treatment for tuberculosis.Methods. This was a retrospective study in six randomly selected health centres in Addis Ababa, Ethiopia. The data were obtained from medical records of TB patients registered from September 2012 to August 2013 and treated under directly observed treatment surgery (DOTS) strategy. KaplanMeier plots, logrank tests, and
In this study, the average recovery time of Tuberculosis patients and the associated risk of treatment failure were examined based on a retrospective moving cohort of sixty-one patients in Northern Region, Ghana. Cox regression was used for multivariate analysis whiles Product-Limit estimator was used to estimate the average recovery time of tuberculosis patients. It was observed that the survival rates for males and females were 85.71% and 88.46% respectively. It was discovered that, age of patient at diagnosis, category, and type of patient were crucial determinants of treatment outcome. The study reported a median recovery time of 22 weeks in the Region. The risk of relapse and death were found to be related to age. It was also realized from the study that most of the deaths occurred within the first three weeks of treatment. Although, it is generally reported that the levels of drug resistance in Africa are lower than in other parts of the world, measures to provide controlled application of second-line drugs, supervision of drug distribution and compliance, enforcement of Directly Observed Therapy-Short course protocols, and sustained training of all personnel involved in tuberculosis management should be enforced for effective combat of the tuberculosis disease.
PLOS ONE, 2021
We reviewed the records of 337 confirmed cases of tuberculosis patients in Monrovia, the capital of Liberia, 2015. The risk factors affecting the survival and multidrug-resistance of tuberculosis patients were examined. Kaplan-Meier analysis and the log-rank test were used to assess the differences in survival among the patients, while Cox regression model was used for multivariate analysis. The qualitative data was tested with chi-square test in the single factor analysis of multidrug-resistant TB. Multivariate analysis was performed using binary logistic regression analysis. The significance level for all the tests were set at 0.05. The mean period of the follow-up of patients was 10 months. In the 337 patients, 33 (9.8%) died, the 21-month survival rate was 90.2%. The results of multivariate Cox regression analysis show that overcrowding (HR = 7.942, 95% CI 3.258–19.356), former smoking (HR = 3.773, 95% CI 1.601–8.889), current smoking (HR = 3.546, 95% CI 1.195–10.521), multidrug...
2018
Multi-drug resistant tuberculosis is a wide spreading global problem. The magnitude of this disease varies significantly from country to country and the treatment outcomes are inadequately described in Ethiopia. Hence, this study aims to assess the survival status and risk factors for mortality of multidrug resistant tuberculosis patients at Adama and Bishoftu General Hospitals. Retrospective cross-sectional study design was conducted among cohorts of multidrug resistant tuberculosis patients treated from May 2013 to August 2017 at Adama and Bishoftu General Hospitals. Data were collected using data abstraction format from 164 patient cards. All patients were used as study participants. Data were analyzed using STATA Version 13 statistical software. Risks were estimated for the entire follow-up time corresponding to each event occurrence using Kaplan-Meier method and the covariates were fitted to Cox Proportional Hazard Regression Model where 164 patients were followed for a total of 63,141 person-days. The median survival time was 400.5 days or 1.1 year. Among 164 patients, 74 (45.10%) were male and the mean age was 31.5 years. There were 30 (18.30%) known deaths and the survival probability of the study participants at 6, 12, 18 and 24 months of treatment was 84%, 82%, 81% and 72%, respectively. In this study: HIV, co-morbidities and co-infections, low initial body weight, age, occupation and Khat use were identified as risk factors for the death of MDR-TB patients. Comparison of these risk factors showed that there is a significant difference in the probability of survival on MDR-TB patients. Cox Regression analysis Model result showed that factors independently associated with mortality of patients were: HIV (HR=2.75,95%CI(1.23-6.15) &P=0.01); low initial body weight(HR=0.44,95% CI(0.22-0.85) &P=0.02); co-morbidities & co-infections (HR=2.28,95% CI (1.99-5.26) & P=0.05); age (HR=2.3,95% CI(1.35-3.79) & P=0.00); Khat use (HR=0.41, 95% CI (0.18-0.97) & P=0.04); Occupation (HR=1.31,95% CI (1.06-1.63) & P=0.01). In conclusion, a higher death rate was noted in patients who started MDR-TB treatment with initial low body weight, HIV positive, co-morbidities & coinfections, age and Khat user.
Determinants of mortality among patients with drug-resistant tuberculosis in northern Nigeria
PLOS ONE, 2019
Background Drug-Resistant tuberculosis (DR-TB) is estimated to cause about 10% of all TB related deaths. There is dearth of data on determinants of DR-TB mortality in Nigeria. Death among DR-TB treated cohorts in Nigeria from 2010 to 2013 was 30%, 29%, 15% and 13% respectively. Our objective was to identify factors affecting survival among DR-TB patients in northern Nigeria. Methods Demographic and clinical data of all DR-TB patients enrolled in Kano, Katsina and Bauchi states of Nigeria between 1 st February 2015 and 30 th November 2016 was used. Survival analysis was done using Kaplan-Meier and multiple regression with Cox proportional hazard modeling. Results Mean time to death during treatment is 19.2 weeks and 3.9 weeks among those awaiting treatment. Death was recorded among 38 of the 147 DR-TB patients assessed. HIV coinfection significantly increased probability of mortality, with an adjusted hazard ratio (aHR) of 2.35, 95% CI: 1.05-5.29, p = 0.038. Treatment delay showed significant negative association with survival (p = 0.000), not starting treatment significantly reduced probability of survival with an aHR of 7.98, 95% CI: 2.83-22.51, p = 0.000. Adjusted hazard ratios for patients started on treatment more than eight weeks after detection or within two to four weeks after detection, was beneficial though not statistically significant with respective pvalues of 0.056 and 0.092. The model of care (facility vs. community-based) did not significantly influence survival.
Long-term survival experience of tuberculosis patients in a rural district of Ghana
International Journal of Science and Research Archive, 2024
There are limited epidemiological studies on the survival of Tuberculosis (TB) patients in Ghana despite the high endemicity of TB in the country. The present study estimated the overall survival time of TB patients and developed a model to determine co-variates associated with death. This was a retrospective cohort study that employed a complete enumeration technique to review patient data from the TB register of the Ajumako Enyan Essiam District, Central Region, Ghana, between August and October 2023. All patients registered for TB care between 1 st January 2018 and 31 st December 2022, excluding patients with incomplete data and drug-resistant cases were included. We applied descriptive statistics, Kaplan-Meier survival analysis, Log-rank test, and a Cox proportional hazard model for multivariate analysis. Out of the 226 eligible patients, 149 (65.9%) were males, 205 (90.7%) were new cases and 37 (17.3%) were TB/HIV co-infected. Those who experienced death were 37 (16.4%), with an overall survival time of 5.5 months (95% CI = 5.4-5.7). Older age (aHR=2.6; 95% CI: 1.1-6.3), male gender (aHR=4.9; 95% CI: 1.7-14.3), relapsed TB patients (aHR=5.2; 95% CI: 2.4-10.9), and TB/HIV co-infected patients (aHR=7.1; 95% CI: 3.6-13.9) were implicated as plausible predictors for survival time to death of TB patients. We concluded there was a significantly low overall survival time for older age, male gender, relapsed TB patients, and TB/HIV co-infected patients. The provision of enhanced training for targeted health professionals and tailored community awareness creation can boost early case detection, treatment adherence, and improve overall survival.
African Health Sciences
Background: Tuberculosis (TB) related mortality remains a serious impediment in ending TB epidemic. Objective: To estimate survival probability and identify predictors, causes and conditions contributing to mortality among TB patients in Vihiga County. Methods: A cohort of 291 patients from 20 purposively selected health facilities were prospectively considered. Data was obtained by validated questionnaires through face-to-face interviews. Survival probabilities were estimated using Kaplan-Meier method while Cox proportional hazard model identified predictors of TB mortality through calculation of hazard ratios at 95% confidence intervals. Mortality audit data was qualitatively categorized to elicit causes and conditions contributing to mortality. Results: 209 (72%) were male, median age was 40 (IQR=32-53) years while TB/HIV coinfection rate was 35%. Overall, 45 (15%) patients died, majority (78% (log rank<0.001)) during intensive phase. The overall mortality rate was 32.2 (95% C...
Barekeng, 2024
Article History: Pulmonary tuberculosis is a serious disease that requires special attention from the community and the Government of Indonesia, especially the Maluku Province. One commonly used analytical method in the health field is survival analysis. Survival analysis is a statistical method related to observing the period until the occurrence of an event or events. This study aims to model and identify factors that affect the recovery rate of patients with pulmonary tuberculosis in Ambon City using Cox Proportional Hazard regression. The results of the Hazard Ratio interpretation show that the variables that have a significant influence are chest pain and night sweats. Specifically, patients experiencing chest pain exhibit a recovery rate 0.487264 times faster than those devoid of such symptoms. Similarly, patients experiencing night sweats demonstrate a recovery rate of 0.619839 times faster than their counterparts not experiencing this symptom. This study highlights the imperative of recognizing and addressing symptoms like chest pain and night sweats in managing pulmonary tuberculosis in Ambon City.