Generic placeholder image

Current Respiratory Medicine Reviews


ISSN (Print): 1573-398X
ISSN (Online): 1875-6387

Research Article

Social Determinants Associated with Tuberculosis Mortality in a General Hospital in Mexico

Author(s): Juan Ángel Ábrego-Fernández and Rafael Laniado-Laborín*

Volume 15 , Issue 1 , 2019

Page: [21 - 25] Pages: 5

DOI: 10.2174/1573398X15666190119160031


Background: Most TB deaths can be prevented with timely diagnosis and appropriate treatment. In fact, millions of people are diagnosed and treated successfully every year, avoiding millions of deaths. However, globally, there are still huge gaps in detection and treatment.

Objective: To identify the social determinants associated with mortality due to TB in a general hospital in Mexico.

Methodology: All patients admitted with a diagnosis of pulmonary tuberculosis to the Emergency Department of a hospital in Mexico were included during a 10-month period. At the end of the study, the condition of discharge of all cases was obtained from the electronic database of the State Tuberculosis Program.

Results: One-hundred and twenty-four patients with tuberculosis were included in the sample. Thirty-eight patients (30.6%) died during their hospital stay and eleven (8.9%) died outside the hospital after their discharge, for a total of 49 (39.5%) deaths. Of the 29 patients with HIV/AIDS, 12 died (41.3%). Logistic regression analysis showed that older age, imprisonment, and previous tuberculosis were significant predictors of mortality.

Conclusion: The mortality of tuberculosis patients diagnosed in HGT is very high, mainly because the diagnosis is established at the hospital level, which implies a late diagnosis.

Keywords: Antituberculosis drugs, HIV, imprisonment, mortality, social determinants, tuberculosis.

Graphical Abstract
Hangreaves JR, Boccia D, Evans CA, Adato M, Petticrew M, Porter JDH. The social determinants of tuberculosis: From evidence to action. Am J Public Health 2011; 11: 654-62.
World. Health Organization. Global tuberculosis report 2017Geneva: World Health Organization;. 2017.Licence: CC BYNCSA 3.0 IGO.
Plataforma Única de Información/SUIVE/DGE/SS. CONAPO Proyección 2010-2050. 2016.cierre CUBOS/DGIS.. http://
Organización Mundial de la Salud, 2013. Definiciones y marco de trabajo para la notificación de tuberculosis-revisión. 2013.ISBN 978 92 4 350534.
Greenaway C, Menzies D, Fanning A, Grewal R, Yuan L, FitzGerald JM. Delay in diagnosis among hospitalized patients with active tuberculosis--predictors and outcomes. Am J Respir Crit Care Med 2002; 165: 927-33.
Counsell SR, Tan JS, Dittus RS. (1989) Unuspected pulmonary tuberculosis in a community teaching hospital. Arch Intern Med 1989; 149: 1274-8.
Moorman J, Edginton ME. Cause of death of patients on treatment for tuberculosis: A study in a rural South African hospital. Int J Tuberc Lung Dis 1999; 3: 786-90.
Walpola HC, Siskind V, Patel AM, Konstantinos A, Derhy P. Tuberculosis-related deaths in Queensland, Australia,1989–1998: characteristics and risk factors. Int J Tuberc Lung Dis 2003; 7: 742-50.
Dewan PK, Arguin PM, Kiryanova H, et al. Risk factors for death during tuberculosis treatment in Orel Russia. Int J Tuberc Lung Dis 2004; 8: 598-602.
Pingzheng M, Zhi Q, Teter C, et al. Prevalence, drug-induced hepatotoxicity, and mortality among patients multi-infected with HIV, tuberculosis, and hepatitis virus. Int J Infect Dis 2014; 28: 95-100.
Pontali E, Centis R. D′Ambrosio L, Migliori GB. Monitoring predictors of mortality: A necessary action to reach TB elimination. Rev Port Pneumol 2015; 21: 295-8.
Workneh MH, Bjune GA, Yimer SA. Diabetes mellitus is associated with increased mortality during tuberculosis treatment: A prospective cohort study among tuberculosis patients in South-Eastern Amahgra Region, Ethiopia. Infect Dis Poverty 2016; 5: 22-31.
Hannah HA, Miramontes R, Gandhi NR. Sociodemographic and clinical risk factors associated with tuberculosis mortality in the United States, 2009-2013. Public Health Rep 2017; 132: 1-10.
MacPherson P, Houben RMGJ, Glynn JR, Corbett EL, Kranzer K. Pre-treatment loss to follow-up in tuberculosis in low- and lower-middle income countries and high burden countries: A systematic review and meta-analysis. Bull World Health Organ 2014; 92: 126-38.
World Health Organization Systematic screening for active tuberculosis WHO/HTM/TB/2013.04..
The UK Collaborative Cohort (UK CHIC) Steering Committee, Sabin CA, Schwenk A, et al. Late diagnosis in the HAART era: Proposed common definitions and associations with mortality. AIDS 2010; 24: 723-7.
Peralta-Gómez I, Cabrera-Rodríguez MC, Gutiérrez-Díaz MJ. Coinfección TB/VIH: Una amenaza para los programas de control de ambas enfermedades. Medicent Electrón 2015; 19: 60-2.

© 2022 Bentham Science Publishers | Privacy Policy