The Influence of Mining and Human Immunodeficiency Virus Infection Among Patients Admitted for Retreatment of Tuberculosis in Northern Tanzania

Am J Trop Med Hyg. 2015 Aug;93(2):212-5. doi: 10.4269/ajtmh.15-0189. Epub 2015 May 26.

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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antitubercular Agents / therapeutic use
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • Humans
  • Male
  • Middle Aged
  • Mining*
  • Prevalence
  • Retreatment
  • Retrospective Studies
  • Risk Factors
  • Tanzania / epidemiology
  • Treatment Outcome
  • Tuberculosis / complications
  • Tuberculosis / drug therapy*
  • Tuberculosis / epidemiology*
  • Young Adult

Substances

  • Antitubercular Agents