Medical Journal of Malaysia

MJM, Vol 70 Supplement 1 September 2015

Outcome of smear-negative tuberculosis cases and its associated factors of mortality in North-East Malaysia

Sarimah A*, Zainurulazma MN*, Sharina D**, Arham Muchtar AB***, Nyi Naing N*

*Unit of Biostatistics & Research Methodology, School of Medical Sciences, USM, **Kelantan State Health Department, ***Universiti Malaysia Kelantan


Introduction: Smear-negative tuberculosis is a symptomatic illness in a patient with at least two smear examinations negative for AFB on different occasions which has contribute to the burden for public health as well as sputum-positive tuberculosis. This study aimed to determine the associated factors of mortality among tuberculosis cases with sputum smear-negative in Northeast Malaysia.

Method: A 5-year review of tuberculosis medical records from year 2010 to 2014 was conducted. The registered cases of tuberculosis records in government hospitals and health clinics in Northeast Malaysia were retrieved and reviewed for socio-demographic, clinical characteristics and outcome of the cases. A Multiple Logistic Regression was used to analyse the factors associated with the mortality outcome.

Results: A total of sputum smear-negative tuberculosis cases were 1697 cases. Only 17.5% died during treatment. All of TB cases with sputum smear-negative involved in this study were male (65.4%) and 94.6% were Malay, Almost 19% were having diabetic, 38.4% were smokers, 78.0% had BCG scar, 91.3% were Pulmonary TB. Majority of them (82.1%) had lesion in the X-ray findings and 18.0% were positive HIV. The significant factors associated with mortality among sputum negative tuberculosis were age (β=0.038, 95%CI (1.020, 1.057), p-value <0.001) and HIV status (Odds Ratio 6.88, 95%CI (3.627, 13.061). X-ray findings were also significant factor for mortality among sputum-negative tuberculosis cases.

Conclusion: Increasing of age, positive HIV status and having lesion on chest X-ray findings were the significant associated factors for mortality among sputum-negative tuberculosis cases. Those who have these factors should be given more attention in order to reduce the mortality among sputum-negative tuberculosis.

Keyword: mortality, sputum-negative tuberculosis, X-ray findings