The Burden of Bacteriologically Negative TB Diagnosis: A Four-Year Review of Tuberculosis Cases at a Tertiary Facility

Jane S Afriyie-Mensah; Robert Aryee; Francisca Zigah; Ernest Amaning-Kwarteng; Marie Nancy Séraphin

doi:10.1155/2023/6648137

The Burden of Bacteriologically Negative TB Diagnosis: A Four-Year Review of Tuberculosis Cases at a Tertiary Facility

Tuberc Res Treat. 2023 Dec 23:2023:6648137. doi: 10.1155/2023/6648137. eCollection 2023.

Authors

Jane S Afriyie-Mensah¹, Robert Aryee^{2

3}, Francisca Zigah⁴, Ernest Amaning-Kwarteng¹, Marie Nancy Séraphin^{5

6}

Affiliations

¹ Department of Medicine and Therapeutics, University of Ghana Medical School, University of Ghana, Accra, Ghana.
² Department of Physiology, University of Ghana Medical School, University of Ghana, Accra, Ghana.
³ Department of Cardiology, University of Ghana Medical Centre, Accra, Ghana.
⁴ Korle-Bu Teaching Hospital, Accra, Ghana.
⁵ Emerging Pathogens Institute, University of Florida, 2055 Mowry Road, P.O. Box 100009, Gainesville, FL 2610, USA.
⁶ Department of Medicine, Division of Infectious Diseases and Global Medicine, College of Medicine, University of Florida, College of Medicine, Gainesville, FL 32610, USA.

Abstract

Aim: We aimed to investigate the demographic and clinical factors associated with TB mortality in patients managed at a tertiary TB referral center.

Methods: We conducted a retrospective review of the medical records of 1,933 TB patients seen between January 2017 and December 2020 at the Korle-Bu Teaching Hospital (KBTH) Chest Department in Accra, Ghana. TB mortality was defined as any TB patient who died for any reason during the course of treatment. Multivariable logistic regression was used to estimate adjusted odds ratios with 95% confidence intervals for factors associated with TB mortality.

Results: A total of 1,933 patients with TB were registered at the chest clinic over the study period. Males accounted for 1,227 (63.5%), and majority of participants were between 24 and 64 years old. Pulmonary TB (PTB) and extrapulmonary TB (EPTB) cases accounted for 51% and 48.4% of the total TB cases, respectively. A significant proportion (69%) of the patients managed for TB had no bacteriological confirmation of the disease. About 34% of tested TB patients were HIV positive. Mortality among patients was 33.6%. In a multivariable regression model, patients with HIV positive status had over 3-fold increased risk of mortality, compared to those with HIV negative status. TB patients diagnosed empirically had an increased risk of death compared to those with a confirmed diagnosis.

Conclusion: The proportion of clinically diagnosed TB was high among the patients seen at the chest clinic. Mortality was high among the patients with HIV/TB coinfection as well as in patients with empirical TB diagnosis.

Grants and funding

K01 AI153544/AI/NIAID NIH HHS/United States