title: Time to Death and Associated Factors among Tuberculosis Patients in Dangila Woreda, Northwest Ethiopia.
abstract: BACKGROUND
  Tuberculosis (TB) is among the leading causes of morbidity and mortality worldwide. More than 70% of the deaths of TB patients occur during the first two months of TB treatment. The major risk factors that increase early death of TB patients are being positive for human immunodeficiency virus (HIV), being of old age, being underweight or undergoing re-treatment.
  
  
  OBJECTIVE
  To assess the time of reported deaths and associated factors in a cohort of patients with TB during TB treatment.
  
  
  METHODS
  An institution-based retrospective cohort study was analyzed in Dangila Woreda, Northwest Ethiopia from March 1st through March 30, 2014. All TB patients registered in the direct observed treatment (DOTs) clinic from 2008-2012 were included in the study. Data were entered into EpiData and exported to SPSS for analysis. The survival probability was analyzed by the Kaplan Meier method and Cox regression analysis was applied to investigate factors associated with death during TB treatment.
  
  
  RESULTS
  From a total of 872 cases registered in TB registry log book, 810 were used for the analysis of which 60 (7.4%) died during the treatment. The overall mortality rate was 12.8/1000 person months of observation. A majority of TB deaths 34 (56.7%) occurred during the intensive phase of the treatment, and the median time of death was at two months of the treatment. Age, HIV status and baseline body weight were independent predictors of death during TB treatment.
  
  
  CONCLUSIONS
  Most deaths occurred in the first two months of TB treatment. Old age, TB/HIV co-infection and a baseline body weight of <35 kg increased the mortality during TB treatment. Therefore, a special follow up of TB patients during the intensive phase, of older patients and of TB/HIV co-infected cases, as well as nutritionally supplementing for underweight patients may be important to consider as interventions to reduce deaths during TB treatment.
authors.affiliation: Department of Monitoring and Evaluation, Addis Ababa City Administration Health Bureau, Yeka Sub-City, Addis Ababa, Ethiopia.
authors.forename: Abayneh
authors.initials: A
authors.lastname: Birlie
authors.affiliation: Department of Medical Laboratory Sciences and Pathology, College of Health Sciences, Jimma University, Jimma, Ethiopia.
authors.forename: Getnet
authors.initials: G
authors.lastname: Tesfaw
authors.affiliation: Department of Statistics, College of Natural Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
authors.forename: Tariku
authors.initials: T
authors.lastname: Dejene
authors.affiliation: Department of Epidemiology, College of Health Sciences, Jimma University, Jimma, Ethiopia.
authors.forename: Kifle
authors.initials: K
authors.lastname: Woldemichael
mesh_terms: D000328:Adult; D003643:Death; D005002:Ethiopia / Q000453:epidemiology; D006801:Humans; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000453:epidemiology*; D055815:Young Adult