Predictors of Tuberculosis Mortality in South Gujarat, India: An Analytical Review of Nikshay Surveillance Data, 2023–2024

Background: Tuberculosis (TB) continues to be a major cause of death in India. Identifying factors associated with TB mortality is crucial for informing targeted actions within the National Tuberculosis Elimination Programme. Materials and Methods: A record-based analytical study was conducted using Nikshay data of TB patients registered in South Gujarat between January 1, 2023, and December 31, 2024. Patients with documented outcomes of “Cured”, “Treatment completed”, or “Deceased” were included. Demographic, clinical, and programmatic variables were analyzed. Bivariate associations were examined using the Chi-square test, and multivariate logistic regression was employed to identify independent predictors of mortality. Subgroup regression analyses were also conducted across sites of TB and types of TB cases to assess potential differences in associations. Results: Among 4795 patients, 187 (3.9%) died. Mortality was highest in patients over 60 years (8.55%), those with low body mass index (6.62%), human immunodeficiency virus (HIV) infection (22%), hypertension (23.53%), and tobacco use (6.14%). In multivariate analysis, independent predictors of mortality included increasing age (adjusted odds ratio [aOR] = 1.03; 95% confidence interval [CI]: 1.02–1.04), low weight (aOR = 0.94; 95% CI: 0.92–0.96), tobacco use (aOR = 2.46; 95% CI: 1.56–3.89), TB contact history (aOR = 10.73; 95% CI: 6.30–18.27), hypertension (aOR = 9.93; 95% CI: 5.12–19.25), HIV infection (aOR = 10.92; 95% CI: 5.85–20.39), slum residence (aOR = 12.04; 95% CI: 7.53–19.26), and migrant status (aOR = 1.69; 95% CI: 1.10–2.61). Conclusions: TB mortality in South Gujarat is closely linked to biomedical, nutritional, and socioenvironmental vulnerabilities. Integrated case management, including comorbidity care, nutritional support, and targeted outreach to slum dwellers, migrants, and people living with HIV, can significantly reduce TB-related deaths.