Cause of death of patients on treatment for tuberculosis: a study in a rural South African hospital.
METHODS
Tintswalo Hospital, a rural district hospital in South Africa.


OBJECTIVE
To assess the quality of data relating to deaths from tuberculosis; to determine the actual cause of death of patients who die whilst on tuberculosis treatment.


METHODS
A descriptive study of all patients who were treated for tuberculosis between January 1992 and June 1996, and who died during their course of treatment. A review of records, X-rays and death certificates of patients whose cause of death was recorded as tuberculosis. Verbal autopsies were done for patients who died at home. Deaths were classified into one of five categories: definitely, likely or possibly due to tuberculosis, unlikely or not due to tuberculosis, based on criteria such as bacteriological confirmation of tuberculosis and the presence of other illnesses.


RESULTS
There were 927 cases of tuberculosis and 80 deaths recorded as due to tuberculosis. Valid criteria or detailed information were available for only 68 patients. Only 56% of deaths were confirmed or likely to be due to tuberculosis, and 12% of patients probably did not have tuberculosis at all. The remaining 32% had tuberculosis but died of other illnesses.


CONCLUSIONS
The recorded tuberculosis mortality data were clearly inaccurate. There is a need to improve tuberculosis diagnosis, documentation on death certificates, and tracing of treatment interrupters in order to determine whether or not they have died.
Moorman
J
J
Department of Community Health, University of Witwatersrand, Johannesburg, South Africa. juliam@gpg.gov.za
Edginton
M E
ME
D017677:Age Distribution; D000995:Antitubercular Agents / Q000627:therapeutic use; D002423:Cause of Death; D006767:Hospitals, District; D006780:Hospitals, Rural; D006801:Humans; D013019:South Africa / Q000453:epidemiology; D014376:Tuberculosis / Q000188:drug therapy / Q000401:mortality*
D000995:Antitubercular Agents