High mortality rates among patients with tuberculosis in Bangui, Central African Republic

Lancet. 1997 Nov 1;350(9087):1298. doi: 10.1016/S0140-6736(05)62475-0.

Abstract

PIP: Survival time until death was investigated in a prospective cohort of 224 tuberculosis patients from Bangui, Central African Republic, who were randomly selected from among 1492 such patients registered in 1993 and 1994. 6 patients (2.7%) presented with extrapulmonary tuberculosis, 186 (83%) were smear-positive, and 139 (62%) were infected with HIV-1. 23 (10.3%) had multidrug-resistant tuberculosis strains. The treatment regimen (isoniazid, rifampicin, ethambutol, and pyrazinamide for 2 months, followed by isoniazid and ethambutol for another 6 months) was successful in 46.4% of HIV-infected patients compared with 67.1% of HIV-negative patients. At the end of 8 months, 39.1% of HIV-infected patients but only 8.2% of HIV-negative patients had died. 24 months after the start of tuberculosis treatment, the cumulative death rate was 58% in HIV-seropositive patients compared with 20% in seronegative patients. Median life expectancy to death among HIV-infected tuberculosis patients was 15 months. Decreased survival was significantly associated with HIV-seropositivity, older age, failure to complete the full treatment regimen, and a low CD4 cell count. Multidrug-resistant tuberculosis was not linked to increased mortality.

Publication types

  • Letter

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Central African Republic / epidemiology
  • Female
  • HIV Seropositivity / complications
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Survival Rate
  • Tuberculosis, Multidrug-Resistant / complications
  • Tuberculosis, Multidrug-Resistant / mortality
  • Tuberculosis, Pulmonary / complications
  • Tuberculosis, Pulmonary / mortality*