Mortality Factors in Tuberculosis Treatment
Summary
Tuberculosis (TB) remains one of the leading infectious causes of death worldwide despite effective chemotherapy. Mortality during TB treatment is driven by a constellation of factors including host characteristics, pathogen traits and health-system deficiencies. Older age and low body mass index reflect diminished physiological reserve and are consistently associated with higher death rates. Concurrent HIV infection and other comorbidities such as diabetes, liver or renal disease compound immunosuppression and worsen prognosis. Drug resistance, notably multidrug-resistant and extensively drug-resistant TB, undermines treatment efficacy and contributes to prolonged infectivity and mortality. Delay in diagnosis or initiation of therapy permits disease progression, while intensive-phase mortality is linked to severe clinical presentations such as bilateral pulmonary involvement or miliary dissemination. Positive acid-fast bacilli smears signal high bacillary load and correlate with increased risk of fatal outcomes. Non-adherence or interruptions in therapy further elevate mortality risk, underscoring the necessity for sustained patient support and directly observed therapy in high-risk settings. Radiographic severity, nutritional status and access to integrated TB–HIV care also determine survival. Recognising these interwoven determinants enables targeted interventions—early case-finding, rapid drug susceptibility testing, multidisciplinary management of comorbidities and adherence support—to reduce the global TB death toll and improve patient outcomes.
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Mortality Factors in Tuberculosis Treatment publication trend
The graph below shows the total number of articles in mortality factors in tuberculosis treatment across all publications each year (not limited to Nature Index journals).
Technical terms
Acid-fast bacilli smear: Microscopic test detecting mycobacteria in sputum to estimate bacillary load.
Body mass index (BMI): Ratio of weight to height squared, indicator of nutritional status.
Multidrug-resistant tuberculosis (MDR-TB): TB caused by strains resistant to at least isoniazid and rifampicin.
Extensively drug-resistant tuberculosis (XDR-TB): MDR-TB with additional resistance to fluoroquinolones and second-line injectable agents.
Bilateral radiographic pattern: Chest imaging finding showing widespread involvement of both lungs.
Comorbidity: Co-existing medical condition that may complicate TB treatment and outcomes.
References
- Genomic, phenotypic and demographic characterization of Mycobacterium tuberculosis in Israel in 2021. Frontiers in Cellular and Infection Microbiology (2023).
- Deaths from tuberculosis: differences between tuberculosis-related and non-tuberculosis-related deaths. Frontiers in Public Health (2023).
- Clinical profiles of early and tuberculosis-related mortality in South Korea between 2015 and 2017: a cross-sectional study. BMC Infectious Diseases (2019).
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