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Causes of death during tuberculosis treatment in Tomsk Oblast, Russia
T A Mathew1, T N Ovsyanikova, S S Shin
1Brigham and Women's Hospital, Boston, Massachusetts, USA. tmathew@partners.org
Setting:
Tuberculosis (TB) incidence and mortality in Russia have risen dramatically over the past 15 years.
Objective:
To identify risk factors and causes of death among TB patients in Russia.
Design:
A retrospective study conducted to determine the risk factors and causes of death in patients receiving TB therapy in Tomsk, Siberia.
Results:
Of 1916 patients who initiated treatment between 1 January 2002 and 31 December 2003, 183 (9.6%) died during treatment, 38 (21%) in the first week of therapy. Twenty-five per cent of deaths were not directly attributable to TB. Risk factors for death included older age, previous treatment for TB, multidrug resistance and alcoholism.
Conclusions:
The high death rate during TB treatment observed in this cohort likely reflects an increased risk of dying not only from TB, but also from comorbid conditions, such as alcoholism and cardiovascular disease. Overall, alcoholism and late presentation both contributed substantially to the mortality in this cohort.
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