title: Overall and cause-specific mortality among patients with tuberculosis and multidrug-resistant tuberculosis.
abstract: OBJECTIVE
  To assess overall and cause-specific mortality among patients with tuberculosis (TB) and multidrug-resistant tuberculosis (MDR-TB) in Estonia.
  
  
  METHODS
  A total of 2449 patients diagnosed with active respiratory TB from 1 January 2002 to 31 December 2009 were followed up retrospectively until 31 December 2011. To estimate the risk of death, standardised mortality ratios (SMR) and mortality rate ratios (RR) were calculated.
  
  
  RESULTS
  The SMR for all-cause mortality among those diagnosed with TB was 5.30 (95%CI 4.85-5.75) in males and 10.00 (95%CI 8.25-11.74) in females. The relative risk of death from TB was higher among MDR-TB patients (adjusted RR in males 2.98, 95%CI 2.00-4.44, and in females 3.26, 95%CI 1.42-7.50) than among non-MDR-TB patients. Among the cohort of successfully treated patients, the SMR for all-cause mortality was 3.46 (95%CI 3.08-3.84) in males and 6.24 (95%CI 4.86-7.88) in females. Lower education level and foreign ethnicity contributed to the higher risk of mortality. Previous history of successfully treated MDR-TB did not increase the risk of death compared to successfully treated non-MDR-TB.
  
  
  CONCLUSIONS
  Mortality among successfully treated TB and MDR-TB patients remained higher than among the general population. It was influenced by foreign ethnicity and lower education but, importantly, not by previous history of MDR-TB.
authors.affiliation: Department of Pulmonary Medicine, University of Tartu, Tartu, Estonia. kaivink@kodu.ee
authors.forename: K
authors.initials: K
authors.lastname: Blöndal
authors.forename: K
authors.initials: K
authors.lastname: Rahu
authors.forename: A
authors.initials: A
authors.lastname: Altraja
authors.forename: P
authors.initials: P
authors.lastname: Viiklepp
authors.forename: M
authors.initials: M
authors.lastname: Rahu
mesh_terms: D000328:Adult; D004522:Educational Status; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D004957:Estonia / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors; D014376:Tuberculosis / Q000453:epidemiology / Q000401:mortality*; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology / Q000401:mortality*