Tuberculosis-related deaths at a tertiary hospital in Zambia: Insights into the prevalence and associated factors

Tuberculosis (TB) mortality remains a significant public health concern globally. This study aimed to determine the prevalence of tuberculosis-related deaths and associated factors among patients at Livingstone University Teaching Hospital (LUTH) Chest Clinic, Zambia. We conducted a retrospective cross-sectional study among 694 individuals (507 adult and 187 children) diagnosed with drug susceptible TB disease between January 1, 2021, and December 31, 2022. Demographic and clinical information were collected from medical records using a data collection form. Multivariable logistic regression was used to determine factors associated with TB-related death. Statistical significance was set at p < 0.05. STATA version 15 was used for all data analysis. The prevalence of TB-related death among adults (above 19 years old) was 18.4% (n = 93) whereas that in children (below 19 years old) was 7.0% (n = 187). Living with HIV (AOR 1.75, 95% CI 1.00-3.08, p = 0.049) was positively associated with TB-related death among the adult patients while being on a family based direct observation therapy (DOT) plan was negatively associated with TB-related death both among adults and among children, (AOR 0.24, 95% CI 0.13-0.45, p <0.001) and (AOR 0.2, 95% CI 0.03-0.99, p = 0.039) respectively. This study found a high TB-related mortality rate, both among adults and children, exceeding the national target of 5% and it was significantly associated with HIV status and DOT plan. There is therefore a need to enhance strategies aimed at reducing TB-related deaths, especially among those living with HIV.