Why are people still dying of drug-susceptible TB in Paris in the 21st century?

• Published in: The international journal of tuberculosis and lung disease Vol. 26; no. 2; pp. 142 - 149
• Main Authors: Beaumont, A-L., Doumbia, A., Château, N., Meynard, J-L., Pacanowski, J., Valin, N., Cadranel, J., Lalande, V., Verdet, C., Lassel, L., Pialoux, G., Fain, O., Morgand, M., Lacombe, K., Surgers, L.
• Format: Journal Article
• Language: English
• Published: International Union Against Tuberculosis and Lung Disease 01-02-2022
• Subjects: Mortality; Prognosis; Retrospective Studies; Risk Factors; Tuberculosis
• ISSN: 1027-3719; 1815-7920
• DOI: 10.5588/ijtld.21.0463

BACKGROUND: Although the burden of TB is lower in France than in low-income countries, patients continue to die from TB in Paris. Our goal was to describe TB-related deaths and to identify associated risk factors.METHODS: We conducted a retrospective cohort study in
two hospitals in Paris between 2013 and 2018. All patients with drug-susceptible TB were included and followed until end of treatment. The primary outcome was death. We performed univariate and multivariate analysis using Cox proportional hazard model.RESULTS: Of the 523 patients
included, 362 were men (median age 37 years), of whom 24 patients died (4.5%). The final survival model concluded that age (HR 1.1 for each additional year), not living in one´s own accommodation (HR 5.9), being born in France (HR 8.0), being alcoholic (HR 4.2), having a history of cancer
(HR 7.1) or meningeal or miliary TB (HR 8.2) were associated with a higher risk of death.CONCLUSION: The rate of TB-associated death is unacceptably high for a curable disease. To note, patients born in France were much more at risk of death than immigrants. We believe raising awareness
among healthcare professionals is a potentially easy and efficient lever for improving care.