Mortality Trends and Risk of Dying From Pulmonary Tuberculosis in the 7 Socioeconomic Regions and the 32 States of Mexico, 2000–2009

BackgroundTuberculosis and HIV remain a public health problem in developed countries. The objective of this study was to analyze the incidence trends of pulmonary TB and HIV comorbidity and treatment outcomes according to HIV during the period 2006 to 2014 in the Mexican Institute of Social Security.MethodsAnalyzed data from this registry including pulmonary tuberculosis patients aged 15 years and older who had been diagnosed during the years 2006 to 2014 in the Mexican Institute of Social Security. The outcomes that we use were incidents rate, failure to treatment and death. Regression models were used to quantify associations between pulmonary tuberculosis and HIV mortality.ResultsDuring the study period, 31,352 patients were registered with pulmonary tuberculosis. The incidence rate observed during 2014 was 11.6 case of PTB per 100,000. The incidence rate for PTB and HIV was 0.345 per 100,000. The PTB incidence rate decreased by 0.07%, differences found in the PTB incidence rate by sex since in women decreased by 5.52% and in man increase by 3.62%. The pulmonary TB with HIV incidence rate decreased by 16.3% during the study period (In women increase 4.81% and in man decrease 21.6%). Analysis of PTB associated with HIV by age groups revealed that the highest incidence rates were observed for the 30 to 44 years old group. Meanwhile, the highest incidence rates of PTB without HIV occurred among the 60 and more years old individuals. We did not find statistically significant differences between treatment failure and PTB patients with HIV and without HIV. The treatment failure was associated with sex and the region of the patient. We found a strong association between HIV and the probability of dying during treatment. Our data suggested that patients suffering from both conditions (PTB and HIV) have no difference in the probability of failure of treatment contrary to other reports. Hypotheses to this is adherence to tuberculosis treatment with people living with HIV/AIDS, detection of PTB in patients suffering from HIV/AIDS or PTB patients on antiretroviral therapy were more likely to have successful treatment outcomes than those not on antiretroviral treatment. We have found that PTB and HIV increases the probability of dying during treatment compared to the cases of PTB without HIV, consistent with published other study HIV increases the mortality rates associated with PTB.ConclusionsNo association between pulmonary tuberculosis with HIV and treatment failure was observed, but pulmonary tuberculosis and HIV increases the probability of dying during treatment compared to the pulmonary tuberculosis cases without HIV.

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“…As reported in other studies where mortality from PTB is associated male sex [21], we found this association to interact with HIV.…”

Section: Discussionsupporting

confidence: 84%

Association of Pulmonary Tuberculosis and HIV in the Mexican Institute of Social Security, 2006-2014

et al. 2016

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“…A common characteristic is that people living in rural areas have low income with respect to those who live in urban areas. Moreover, it has been reported that in the states and economical regions of Mexico with lower income, the number of registered TB cases is greater for men than for women, indicating that such differences correspond not only to biological or epidemiological characteristics but also to socioeconomic and cultural aspects and access to health systems [17]. However, it has been observed that people with little or no formal education are socially, geographically and/or economically marginalized and present with a compromised health status associated with TB morbidity and mortality [17].…”

Section: Discussionmentioning

confidence: 99%

Nutritional status evaluation and nutrient intake in adult patients with pulmonary tuberculosis and their contacts

Campos-Góngora

López-Martínez

Huerta-Oros

et al. 2019

J Infect Dev Ctries

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Introduction: Malnutrition is a common status in patients with tuberculosis (TB). Because TB is disseminated through the sputum of infected persons, individuals who maintain relations with a TB patient are at high risk of infection; this risk is greater when contacts present an inadequate nutritional status. The aim of this work was to analyse and compare the nutritional status and macro and micronutrient intake of TB patients and their household contacts. Methodology: A cross-sectional study was carried out in TB patients from Nuevo Leon, México, and their household contacts. Thirty-nine patients diagnosed with TB and 62 contacts were evaluated. Anthropometric evaluation was performed considering weight, height, body mass index (BMI) and waist-hip ratio (WHR); nutrient intake was evaluated by applying 24-hour dietary recalls. Results: According to anthropometric assessment, the study population showed a greater trend towards being overweight and obese; 62% of TB patients and contacts had this type of malnutrition, while only 8% of individuals were undernourished. A greater tendency towards malnutrition was observed in the TB patient group. Conclusions: TB patients and their contacts presented as overweight and obese. Both groups showed similar patterns in macro and micronutrient intake. Implications of deficiencies in the intake of these nutrients are discussed on the basis of their effects on individual health.

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“…Individuals with low socioeconomic status, including low or no education, have higher TB risk and prevalence, are less likely to seek medical care, have longer diagnosis delay time, and are at higher risk of death from TB. 16,17 Populations with little or no education are generally disadvantaged from a social, geographic, or economical point of view, all factors that are associated with TB morbidity and mortality. 16 In addition, low education is associated with poor knowledge of TB and attitude to the disease, which can facilitate transmission and can lead to delaying health-seeking behavior, lack of adherence to treatment regimes, treatment failure and disease complications, and death.…”

Section: Discussionmentioning

confidence: 99%

“…16,17 Populations with little or no education are generally disadvantaged from a social, geographic, or economical point of view, all factors that are associated with TB morbidity and mortality. 16 In addition, low education is associated with poor knowledge of TB and attitude to the disease, which can facilitate transmission and can lead to delaying health-seeking behavior, lack of adherence to treatment regimes, treatment failure and disease complications, and death. 18 Worldwide, TB is more prevalent in males than females, and males tend to have higher prevalence of undiagnosed TB than females.…”

Section: Discussionmentioning

confidence: 99%

Undiagnosed Active Pulmonary Tuberculosis among Pilgrims during the 2015 Hajj Mass Gathering: A Prospective Cross-sectional Study

Yezli

Zumla

Yassin

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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Mass gatherings pose a risk for tuberculosis (TB) transmission and reactivation of latent TB infection. The annual Hajj pilgrimage attracts 2 million pilgrims many from high TB-endemic countries. We evaluated the burden of undiagnosed active pulmonary TB in pilgrims attending the 2015 Hajj mass gathering. We conducted a prospective cross-sectional study in Mecca, Kingdom of Saudi Arabia, for nonhospitalized adult pilgrims from five high TB-endemic countries. Enrollment criteria were the presence of a cough and the ability to produce a sputum sample. Sputum samples were processed using the Xpert MTB-RIF assay. Data were analyzed for drug-resistant TB, risk factors, and comorbidities by the country of origin. Of 1,164 consenting pilgrims enrolled from five countries: Afghanistan (316), Bangladesh (222), Nigeria (176), Pakistan (302), and South Africa (148), laboratory results were available for 1,063 (91.3%). The mean age of pilgrims was 54.5 (range = 18-94 years) with a male to female ratio of 2.6:1; 27.7% had an underlying comorbidity, with hypertension and diabetes being the most common, 20% were smokers, and 2.8% gave a history of previous TB treatment. Fifteen pilgrims (1.4%) had active previously undiagnosed drug-sensitive pulmonary TB (Afghanistan [12; 80%], Pakistan [2; 13.3%], and Nigeria [1; 6.7%]). No multidrug-resistant TB cases were detected. Pilgrims from high TB-endemic Asian and African countries with undiagnosed active pulmonary TB pose a risk to other pilgrims from over 180 countries. Further studies are required to define the scale of the TB problem during the Hajj mass gathering and the development of proactive screening, treatment and prevention guidelines.

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Mortality Trends and Risk of Dying From Pulmonary Tuberculosis in the 7 Socioeconomic Regions and the 32 States of Mexico, 2000–2009

Cited by 17 publications

References 14 publications

Association of Pulmonary Tuberculosis and HIV in the Mexican Institute of Social Security, 2006-2014

Association of Pulmonary Tuberculosis and HIV in the Mexican Institute of Social Security, 2006-2014

Nutritional status evaluation and nutrient intake in adult patients with pulmonary tuberculosis and their contacts

Undiagnosed Active Pulmonary Tuberculosis among Pilgrims during the 2015 Hajj Mass Gathering: A Prospective Cross-sectional Study

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