Factors Associated with Death among Tuberculosis Patients Followed at Ignace Deen Hospital in Conakry, Guinea

Introduction: In many countries, large numbers of tuberculosis patients continue to die despite the efforts of control programmes. The aim of this study was to identify the factors associated with death in patients. Material and Methods: This was a retrospective cohort study using routine data from the respiratory medicine department of Ignace Deen Hospital in Conakry (Guinea) over a 6-year period (from 1 January 2015 to 31 December 2020). A multivariate analysis using the Cox model was used to identify the factors associated with death, using R software. The significance level was set at 0.05 for the final model. Results: During the study period, 1,579 patients with tuberculosis were seen in the department, of whom 618 were included. The median age was 39, with extremes of 28 and 51. There was a predominance of men (69.90%). The majority marital status was single (71.52%). The main clinical signs were cough (87.38%), chest pain (66.99%) and night sweats (77.35%). Paraclinically, bacilloscopy was positive in 79.77% of cases. The mortality rate was 10%. In multivariate analysis, the factors independently associated with the occurrence of death in patients with tuberculosis were body mass index < 17.5 kg/m2 (adjusted RR = 4.32 [2.28-8.17] ; adjusted p-value < 0.0001); chronic obstructive pulmonary disease (adjusted RR = 10.83 [5.01-23.41]; adjusted p-value < 0.0001); diabetes (adjusted RR = 9.41 [3.63-24.41]; adjusted p-value < 0.0001) and HIV status (RR = 2.67 [1.42-5.03]; adjusted p-value = 0.00229). Conclusion: These results underline the need to strengthen the overall management of tuberculosis patients, particularly those with identified risk factors, by stepping up efforts in the areas of early detection, nutritional support and management of co-morbidities.