Mortality Profile of Tuberculosis Patients in Mandya District - A Cross-Sectional Study

Abstract

Introduction: Tuberculosis (TB) remains a leading cause of mortality globally, especially among immunocompromised individuals such as those living with HIV. In 2022, TB accounted for 1.3 million deaths among HIV-negative individuals and 167,000 among PLHIV. Mortality in TB patients is influenced by factors like age, comorbidities (e.g., malignancy, liver and renal failure), and radiographic patterns. The COVID-19 pandemic significantly disrupted TB services, resulting in reduced case detection and a subsequent rise in TB deaths. Risk factors like sputum positivity, drug resistance, diabetes, and HIV were found to contribute to TB mortality. Objectives are to describe the mortality pattern of TB patients registered under NTEP in Mandya district (2018–2023) and to identify risk factors associated with TB mortality. Methodology: A facility-based cross-sectional study was conducted involving 168 TB death cases reported between Feb 2018 and Dec 2023. Data were collected via telephonic interviews with close relatives. Complete enumeration was used, and inclusion criteria focused on confirmed TB deaths under NTEP. Data were analyzed using descriptive and bivariate methods. Results: Most deaths occurred in males (76%) and individuals aged >60 years (39.2%). Pulmonary TB was present in 84% of cases, and 91.6% were on treatment. Respiratory insufficiency was the leading cause of death (79.6%). Deaths at home were more common (62%). COVID-19 years showed fewer deaths but with shorter diagnosis-to-death durations and longer hospital stays, suggesting pandemic-related service disruptions. Conclusion: TB mortality (2018–2023) in Mandya was higher among older, less literate males, with home deaths and COVID-19-related care disruptions highlighting the need for early detection and better healthcare access.