Table 1 Studies included the TB mortality review ranked by case fatality ratio, 2010–2018 (n = 24)
From: A systematic review of risk factors for mortality among tuberculosis patients in South Africa
First author and design | Year a | DST pattern | Study location | Study population | Sample size | Deaths | CFR b (%) | Main risk factors identified (effect measure) |
|---|---|---|---|---|---|---|---|---|
Pietersen [17] Prospective Cohort | 2014 | XDR | Western sub-district, Cape Town, Western Cape; Upington, Northern Cape; Johannesburg, Gauteng. | Adult XDR-TB patients | 107 | 78 | 72.9 | HIV status; ART; gender; net conversion; net reversion; age at diagnosis; drugs in treatment regimen; mixed ancestry (HR) |
Gandhi [18] Case Control | 2012 | MDR, XDR | Tugela Ferry, KwaZulu-Natal | HIV+ adult MDR- and XDR-TB patients | 262 | 189 | 72.1 | CD4 count; drug resistance pattern; ART status (HR) |
Kvasnovsky [28] Retrospective Cohort | 2011 | XDR | Port Elizabeth, Eastern Cape | TB patients starting treatment | 274 | 160 | 58.4 | Age; weight; bilateral cavity disease; smear; previous TB treatment; status; year; ART status (OR) |
Pietersen [29] Retrospective Cohort | 2015 | XDR | Western Cape and Northern Cape | Adults (≥ 18) with genotyped isolates | 178 | 93 | 52.2 | Weight at diagnosis; HIV status; Capreomycin resistance; TB drugs (Capreomycin, Moxifloxacin; Co-amoxicillin/clavulanic acid) (OR) |
Marais [30] Retrospective Review | 2011 | DS, MDR | Manenberg, Cape Town, Western Cape | Adults with CSF-confirmed TBM. | 120 | 59 | 49.2 | CD4; British Medical Research Council TBM disease grade (OR) |
O'Donnell [31] Retrospective Cohort | 2013 | XDR | KwaZulu-Natal | XDR TB adult (>Â 18Â years of age) | 114 | 48 | 42.1 | Gender; previous TB treatment; HIV status; culture conversion within 2Â months; ART (HR) |
Dheda [32] Retrospective Cohort | 2010 | XDR | Western Cape, Eastern Cape, Northern Cape, Gauteng | Adults (≥ 16) | 199 | 83 | 41.7 | Regimen; previous TB treatment; HIV (HR) |
Olaleye [33] Retrospective Cohort | 2016 | MDR | Witbank, Mpumalanga | Adults | 442 | 151 | 34.2 | Smear; HIV status; gender; age (HR) |
Janssen [34] Prospective Cohort | 2017 | DS | Khayelitsha, Cape Town, Western Cape | HIV+ adults with CD4+ <Â 350 | 60 | 16 | 26.7 | Mycobacteremia; treatment delay (HR) |
Umanah [35] Retrospective Review | 2015 | MDR | Johannesburg, Gauteng | HIV+ adults (≥ 18) alive > 24 h of initiating Rx. | 947 | 181 | 19.1 | Weight; TB location; regimen; age; sex; CD4; co-morbidity; adverse events; other opportunistic infections; cavitary radiograph changes (OR) |
Marais [36] Retrospective Review | 2014 | MDR | Johannesburg, Gauteng | MDR TB patients in hospital | 351 | 65 | 18.5 | Diagnosis year; gender; TB strain; age (OR) |
Brust [37] Retrospective Cohort | 2010 | MDR | Durban, KwaZulu-Natal | Minimum age not specified (9.6% reported <Â 20Â years old). | 1 209 | 223 | 18.4 | HIV status; previous TB treatment; mono-resistance (Ethambutol); year (OR) |
Pepper [38] Prospective Cohort | 2011 | DS, MDR | Cape Town, Western Cape | HIV+ adults eligible for ART at TB diagnosis | 100 | 15 | 15 | CD4+ count, 100 cells/mL (OR) |
Lawn [39] Prospective Cohort | 2017 | DS, RIF mono | Klipfontein, Cape Town, Western Cape | HIV+ adults (≥ 18) | 139 | 19 | 13.7 | u-LAM; gender; mono-resistance (HR) |
Griesel [40] Prospective Cohort | 2018 | NS | Cape Town, Western Cape | Hospitalised HIV+ adults (≥ 18), cough and one WHO danger sign | 255 | 34 | 13.3 | Respiratory rate; temperature; patient-ambulance; HIV status; BMI; ART; hypotension; confusion (OR) |
Field [41] Retrospective Review | 2014 | NS | North West Province (Platinum Mine) | Adult miners | 4 162 | 509 | 12.2 | Diagnosis age; diagnostic certainty; HIV/ART status; TB location (IRR) |
Kerkhoff [42] Prospective Cohort | 2016 | NS | Cape Town, Western Cape | HIV+ adults; ART naïve or newly diagnosed | 174 | 21 | 12.1 | Hepcidin level; HIV status-CD4; HIV status-viral load; ambulation (HR) |
Kendon [43] Retrospective Review | 2012 | NS | Durban, KwaZulu-Natal | HIV+ adult in-patients on TB therapy for HIV-associated TB and adults on TB therapy at ART initiation | 458 | 55 | 12.0 | ART timing; renal impairment; inpatient initiation; TB site (HR) |
Brust [44] Prospective Cohort | 2018 | MDR | KwaZulu-Natal | Adults (≥ 18) | 206 | 24 | 11.7 | Age; HIV status; previous TB treatment, chest radiograph; gender; CD4 (HR) |
Loveday [45] Prospective Cohort | 2012 | MDR | KwaZulu-Natal (Specialised TB hospital, 4 MDR sites) | MDR TB adults (≥ 18); | 860 | 97 | 11.3 | Site; age (OR) |
Seddon [46] Retrospective Cohort | 2012 | DS, MDR, INH mono, RIF mono | Cape Town, Western Cape | Children under 13Â years confirmed or probable TBM. | 123 | 11 | 8.9 | MDR TB; HIV status (OR) |
Abdool Karim [47] Randomised Control Trial | 2010 | NS | Durban, KwaZulu-Natal | Adult smear+ HIV+ with CD4+ counts <Â 500 cells/mm3 | 642 | 52 | 8.1 | Integrated vs sequential ART (HR) |
Churchyard [48] Randomised Control Trial | 2011 | DS | Free State | Adult miners | 1 302 | 104 | 8.0 | Screening-timing at 6 and 12Â months (HR) |
Yotebieng [49] Retrospective Cohort | 2010 | DS | Soweto, Johannesburg, Gauteng | ART-naive HIV+ children initiated on TB treatment | 573 | 37 | 6.5 | HIV status; ART timing; weight (HR) |