TB outcomes and mortality risk factors in adult migrants at the Thailand-Myanmar border
BACKGROUND: Cross-border migrants at the Thailand-Myanmar border are an underserved and vulnerable population. We aimed to identify the causes and risk factors for TB mortality at a migrant-friendly TB programme.METHODS: Routinely collected data on TB cases, treatment outcomes and causes of death we...
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th-mahidol.600692020-11-18T17:02:40Z TB outcomes and mortality risk factors in adult migrants at the Thailand-Myanmar border A. Carroll M. Vincenti-Delmas B. Maung Maung W. P.P. Htun F. Nosten C. Smith P. Sonnenberg Shoklo Malaria Research Unit University College London Nuffield Department of Medicine Medicine BACKGROUND: Cross-border migrants at the Thailand-Myanmar border are an underserved and vulnerable population. We aimed to identify the causes and risk factors for TB mortality at a migrant-friendly TB programme.METHODS: Routinely collected data on TB cases, treatment outcomes and causes of death were analysed for adult TB cases diagnosed between January 2013 and April 2017. Mortality in the 6 months post-diagnosis was calculated and risk factors were identified using multivariable Poisson regression.RESULTS: Of the 1344 TB cases diagnosed, 1005 started treatment and 128 died. Case fatality rate was 9.5% and the TB mortality rate was 2.4/100 person-months. The number of pre-treatment deaths (33/128) and losses to follow-up (9.0%) were high. Among cases enrolled in treatment, the treatment success rate was 79.8%. When stratified by HIV status, case fatality was higher in HIV-positive cases not on antiretroviral therapy (ART) (90.3%) or with unknown HIV status (31.8%) than those on ART (14.3%) or HIV-negative (8.6%).CONCLUSION: This TB programme achieved high treatment success rates in a population with a substantial burden of TB-HIV coinfection. Expanding access to HIV testing and ART is crucial to reduce mortality. Striving towards same-day TB diagnosis and treatment could reduce death and loss to follow-up. 2020-11-18T10:02:40Z 2020-11-18T10:02:40Z 2020-10-01 Article The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. Vol.24, No.10 (2020), 1009-1015 10.5588/ijtld.20.0014 18157920 2-s2.0-85094935409 https://repository.li.mahidol.ac.th/handle/123456789/60069 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85094935409&origin=inward |
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Medicine A. Carroll M. Vincenti-Delmas B. Maung Maung W. P.P. Htun F. Nosten C. Smith P. Sonnenberg TB outcomes and mortality risk factors in adult migrants at the Thailand-Myanmar border |
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BACKGROUND: Cross-border migrants at the Thailand-Myanmar border are an underserved and vulnerable population. We aimed to identify the causes and risk factors for TB mortality at a migrant-friendly TB programme.METHODS: Routinely collected data on TB cases, treatment outcomes and causes of death were analysed for adult TB cases diagnosed between January 2013 and April 2017. Mortality in the 6 months post-diagnosis was calculated and risk factors were identified using multivariable Poisson regression.RESULTS: Of the 1344 TB cases diagnosed, 1005 started treatment and 128 died. Case fatality rate was 9.5% and the TB mortality rate was 2.4/100 person-months. The number of pre-treatment deaths (33/128) and losses to follow-up (9.0%) were high. Among cases enrolled in treatment, the treatment success rate was 79.8%. When stratified by HIV status, case fatality was higher in HIV-positive cases not on antiretroviral therapy (ART) (90.3%) or with unknown HIV status (31.8%) than those on ART (14.3%) or HIV-negative (8.6%).CONCLUSION: This TB programme achieved high treatment success rates in a population with a substantial burden of TB-HIV coinfection. Expanding access to HIV testing and ART is crucial to reduce mortality. Striving towards same-day TB diagnosis and treatment could reduce death and loss to follow-up. |
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Shoklo Malaria Research Unit |
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Shoklo Malaria Research Unit A. Carroll M. Vincenti-Delmas B. Maung Maung W. P.P. Htun F. Nosten C. Smith P. Sonnenberg |
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Article |
author |
A. Carroll M. Vincenti-Delmas B. Maung Maung W. P.P. Htun F. Nosten C. Smith P. Sonnenberg |
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A. Carroll |
title |
TB outcomes and mortality risk factors in adult migrants at the Thailand-Myanmar border |
title_short |
TB outcomes and mortality risk factors in adult migrants at the Thailand-Myanmar border |
title_full |
TB outcomes and mortality risk factors in adult migrants at the Thailand-Myanmar border |
title_fullStr |
TB outcomes and mortality risk factors in adult migrants at the Thailand-Myanmar border |
title_full_unstemmed |
TB outcomes and mortality risk factors in adult migrants at the Thailand-Myanmar border |
title_sort |
tb outcomes and mortality risk factors in adult migrants at the thailand-myanmar border |
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2020 |
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https://repository.li.mahidol.ac.th/handle/123456789/60069 |
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1763490619353726976 |