Patients with tuberculosis in Bolivia: why do they die?
The objective of this research was to analyze why patients with tuberculosis (TB) die and to evaluate whether there are factors contributing to their fatal outcome that could be corrected. A cross-sectional observational study was conducted of the patients with active TB or its sequelae admitted to the TB ward of the main public hospital in the city of Santa Cruz, Bolivia, over a 29-month period, from October 1993 through February 1996. The available records of the patients who died during hospitalization were reviewed. Out of 597 patients, 94 of them (15.7 por cent) died. We examined the records of 90 of these 94 patients. Their mean age was 35.1 years (standard deviation, 16.7 years), and 45 of the patients (50.0 por cent) were male. On admission 42 of the 90 patients (46.7 por cent) had never been treated for TB or had received anti-TB treatment for less than one month, 23 (25.6 por cent) had returned after having abandoned their TB treatment, 8 (8.9 por cent) had had an erroneous diagnosis, 6 (6.7 por cent) had tuberculosis sequelae, 6 (6.7 por cent) were undergoing tuberculosis treatment, and 5 (5.6 por cent) were known to have multidrug-resistant TB. Of the 90 patients, 83 (92.2 por cent) had pulmonary tuberculosis (median lobes affected, 4), 6 (6.7 por cent) had pleural tuberculosis, and 12 (13.3 por cent) had extrapulmonary tuberculosis (some patients had more than one form of TB). Patients died a median of 5.5 days after entering the TB ward. The causes of death were: hemoptysis, 6 patients (6.7 por cent); nontuberculosis causes, 6 patients (6.7 por cent); and undetermined causes, 7 patients (7.8 por cent). Factors possibly contributing to death were late diagnosis (38.9 por cent), errors in follow-up (14.4 por cent), and errors in treatment (24.4 por cent). In conclusion, most patients with active or inactive TB admitted to our ward died as a consequence of tuberculosis. There were several factors possibly contributing to their fatal outcome that could be corrected
Olle-Goig, Jaime E (2000) Patients with tuberculosis in Bolivia: why do they die?. Rev Panam Salud Publica;8(3) -,sept. 2000. Retrieved from http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892000000800001&lng=pt&nrm=iso
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