title: Stable incidence rates of tuberculosis (TB) among human immunodeficiency virus (HIV)-negative South African gold miners during a decade of epidemic HIV-associated TB.
abstract: During the last decade, annual tuberculosis (TB) case-notification rates increased 4-fold, to >4000 cases/100000 person-years, in the study workforce, among whom prevalence of human immunodeficiency virus (HIV) was 30% in 2000. Three separate cohort studies, totalling 6454 HIV-negative participants, were combined and analyzed for time trends. Observed incidence of TB varied between 962 (1991-1994) and 1589 (1999-2000) cases/100000 person-years (P=.17, test for trend). There was, however, a progressive increase in age, and, for each period, older age was associated with increased incidence rates of TB (P<.001). Having adjusted for age differences, there was no significant association between incidence of TB and calendar period (P=.81, test for trend). Relative to 1991-1994, multivariate-adjusted incidence-rate ratios were 0.94, for 1995-1997, 0.96, for 1998-1999, and 1.05, for 1999-2000. Preventing a secondary epidemic of TB among HIV-negative individuals may be achievable with conventional means, even in settings with a high burden of HIV-associated TB.
authors.affiliation: Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom. elc1@mweb.co.zw.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Corbett
authors.forename: Salome
authors.initials: S
authors.lastname: Charalambous
authors.forename: Katherine
authors.initials: K
authors.lastname: Fielding
authors.forename: Tim
authors.initials: T
authors.lastname: Clayton
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Hayes
authors.forename: Kevin M
authors.initials: KM
authors.lastname: De Cock
authors.forename: Gavin J
authors.initials: GJ
authors.lastname: Churchyard
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004196:Disease Outbreaks; D006046:Gold; D018023:HIV Seronegativity; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008906:Mining; D011446:Prospective Studies; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology; D013997:Time Factors; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*
chemical_list: D006046:Gold