Predictive Factors of Mortality of Tuberculosis Patients Dead of Tuberculosis in Côte d'Ivoire

Abstract

Introduction: study of the predictive factors of the deaths of tuberculosis patients to propose a decision tree for their best care in ambulatory TB centers. Methods: Prospective and observational survey, on a sample of 939 tuberculosis patients recruited in 30 CAT/CDT, carried out during supervision using collection tools such as survey forms and tuberculosis patient files. Results: 55 patients were notified dead. The mortality rate during tuberculosis was 5.9%. The Independent Factors Inducing Death (IFID) of TB were illiteracy, asthma associated with tuberculosis, assimilation of tuberculosis to witchcraft, radiological involvement of the pulmonary territories, serum creatinine ≥ 28 mg/L, HIV infection associated with TB. Associated with severe anemia for clinical concern, these factors allowed the development of the predictive score of death from TB. The ROC curve of the predictive score at death estimated the relevance of the predictive value of death with an area under the curve of 0.834 (0.755 – 0.912) (p < 0.001). The negative predictive value (NPV) of the predictive score for death during TB varied between 94.08% and 98.95%. This score is calculated on two groups of IFID. The 1st group is made up of socio-demographic factors. The 2nd group is made up of morbid situations requiring care in a specialized environment. Conclusion: The IFID imposes a management based on the use of the interrogation and the minimal radiological and biological assessment (the chest X-ray, the blood count, the dosage of creatinine and HIV serology). The decision tree-based death reduction strategy will contribute to better referral and management of patients.

Symptom Clusters