title: The Influence of Mining and Human Immunodeficiency Virus Infection Among Patients Admitted for Retreatment of Tuberculosis in Northern Tanzania.
abstract: In tuberculosis (TB)-prevalent settings, patients admitted for retreatment of TB may account for a high burden of poor treatment outcome. We performed a retrospective cohort study to characterize retreatment patients and outcomes at a TB referral hospital in northern Tanzania. From 2009 to 2013, 185 patients began a retreatment regimen, the majority for relapse after prior treatment completion. Men accounted for an unexpected majority (88%), 36 (20%) were human immunodeficiency virus (HIV) infected and for 45 (24%) mining was their primary occupation. A poor outcome (death, default, or persistent smear positivity after 7 months of treatment) was found in 37 (23%). HIV infection was the only significant predictor of poor outcome (adjusted odds ratio [aOR] = 2.50, 95% confidence interval [CI] = 1.07-5.83, P = 0.034). Interventions to minimize need for retreatment or improve retreatment success may be regionally specific. In our setting, community-based diagnosis and management among at-risk subpopulations such as miners and those HIV infected appear of highest yield.
authors.affiliation: Kibong'oto Infectious Disease Hospital, Kilimanjaro, United Republic of Tanzania; Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia.
authors.forename: Stellah G
authors.initials: SG
authors.lastname: Mpagama
authors.affiliation: Kibong'oto Infectious Disease Hospital, Kilimanjaro, United Republic of Tanzania; Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia.
authors.forename: Isaack A
authors.initials: IA
authors.lastname: Lekule
authors.affiliation: Kibong'oto Infectious Disease Hospital, Kilimanjaro, United Republic of Tanzania; Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia.
authors.forename: Alexander W
authors.initials: AW
authors.lastname: Mbuya
authors.affiliation: Kibong'oto Infectious Disease Hospital, Kilimanjaro, United Republic of Tanzania; Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia.
authors.forename: Riziki M
authors.initials: RM
authors.lastname: Kisonga
authors.affiliation: Kibong'oto Infectious Disease Hospital, Kilimanjaro, United Republic of Tanzania; Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia skh8r@virginia.edu.
authors.forename: Scott K
authors.initials: SK
authors.lastname: Heysell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008906:Mining; D015995:Prevalence; D019233:Retreatment; D012189:Retrospective Studies; D012307:Risk Factors; D013636:Tanzania / Q000453:epidemiology; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents