Survival and Determinants of Mortality among Pulmonary Tuberculosis Patients in Sakon Nakhon Province, Northeastern Thailand

Background In 2022, there were 10.6 million new cases of tuberculosis (TB) and 1.3 million deaths from TB globally; it remains one of the most common causes of death from infectious diseases. Even though there have been considerable improvements in controlling TB, not enough is known about predicting long-term survival for TB patients, especially in rural community of the northeastern, Thailand. Methods A retrospective cohort study was conducted data (2014–2023) on 9,289 pulmonary and extrapulmonary tuberculosis patients in Sakon Nakhon province, Thailand. Data were retrieved from the National TB Information System (NTIP), which was refined to a cohort (n = 8,895) subsequent to the exclusion of transfers and modifications of diagnoses. Analysis was based on the Kaplan-Meier survival curve, Log rank test and a Cox proportional hazard model, with statistical significance set at p < 0.05. Results Among the 9,289 TB patients (mean 52.6 ± 16.7 years): 63.6% were male (male-to-female ratio, 1.74:1); 21.6% had HIV coinfection; and drug resistance was 0.4%. The overall treatment success rate was 85.6—46.8% with 38.8% completing the course. The overall death rate during treatment was 7.4%, while the early death rate (within 2 months) was 3.8%. The median survival was around 6.0 months (mean 6.6 ± 3.0 months). The success rate declined from 92.1% to 82.6% over the decade of analysis, with a modest dip observed during the 2021–2023 period. Mortality was independently associated with age ≥ 65 years (aHR 2.73; 95% CI 2.17–3.42), and HIV coinfection (aHR 1.53; 95% CI 1.26–1.84). Conclusions The overall median survival time of the TB patients was 6.0 months. The factors affecting patient survival were age ≥ 65 years and HIV coinfection. There was an upward trends in the mortality rate.