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J Res Health Sci. 2021;21(2): e00513.
doi: 10.34172/jrhs.2021.50
PMID: 34465635
PMCID: PMC8957672
Scopus ID: 85110782459
  Abstract View: 149
  PDF Download: 75
  Full Text View: 53

Original Article

Modeling Time to Death of Patients with Multidrug-Resistant Tuberculosis at Saint Peter’s Specialized Hospital

Teramaj Wongel Wotale, Abiyot Negash Terefe*, Jaleta Abdisa Fufa
*Corresponding Author: Email: abiyotnegash@yahoo.com

Abstract

Background: Currently, the worldwide prevalence and incidence of multidrug-resistant tuberculosis (MDR-TB) is drastically increasing. The main objective of this study was modeling the time-to-death of patients with MDR-TB at St. Peter’s Specialized Hospital, Addis Ababa, Ethiopia, by using various parametric shared frailty models.

Study Design: A retrospective study design was used.

Methods: The study population was TB patients with MDR at St. Peter’s Specialized Hospital from January 2016 through December 2019. Exponential, Weibull, and log-normal were used as baseline hazard functions with the gamma and inverse Gaussian frailty distributions. All the models were compared based on Akaike’s Information Criteria.

Results: The overall median time to death was 11 months and 123 (33.5%) patients died. Patients who lived in rural areas had shorter survival time than those who lived in urban areas with an accelerated factor of 0.135 (P=0.002). Patients with a history of anti-TB drug consumption had a short survival time than those without such a history with an accelerated factor of 0.02 (P=0.001). The variability (heterogeneity) of time to death of patients in the region for the selected model (Weibull-inverse Gaussian shared frailty model) was =0.144 (P=0.027).

Conclusion: The MDR-TB patients with weight gain, khat and alcohol consumption, clinical complication of pneumothorax and pneumonia, extrapulmonary TB, and history of anti-TB drug consumption as well as those who lived in rural areas had a shorter survival time, compared to others. There was a significant heterogeneity effect in the St. Peter’s Specialized Hospital. The best model for predicting the time to death of MDR-TB patients was Weibull-inverse Gaussian shared frailty model.
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Submitted: 26 Feb 2021
Revision: 30 Jun 2021
ePublished: 19 May 2021
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