Trial reportThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease2011
Risk factors for mortality in smear-negative tuberculosis suspects: a cohort study in Harare, Zimbabwe.
Trial report in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 5 of them syntheses that pooled it.
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Who cites it
45 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Factors associated with severity of pulmonary tuberculosis in people living with and without HIV: a systematic review.BMC infectious diseases · 2026Pooled it
- Factors associated with tuberculosis treatment initiation among bacteriologically negative individuals evaluated for tuberculosis: An individual patient data meta-analysis.PLoS medicine · 2025Pooled it
- High HIV and active tuberculosis prevalence and increased mortality risk in adults with symptoms of TB: a systematic review and meta-analyses.Journal of the International AIDS Society · 2018Pooled it
- Pre-treatment loss to follow-up in tuberculosis patients in low- and lower-middle-income countries and high-burden countries: a systematic review and meta-analysis.Bulletin of the World Health Organization · 2014Pooled it
- Prevalence of TB/HIV co-infection in countries except China: a systematic review and meta-analysis.PloS one · 2013Pooled it
- Clinical Impact of the Line Probe Assay and Xpert® MTB/RIF Assay in the Presumptive Diagnosis of Drug-Resistant Tuberculosis in Brazil: A Pragmatic Clinical Trial.Revista da Sociedade Brasileira de Medicina Tropical · 2022Trial
- A randomized controlled trial of standard versus intensified tuberculosis diagnostics on treatment decisions by physicians in Northern Tanzania.BMC infectious diseases · 2014Trial
- Evaluation of Xpert MTB/RIF Ultra performance on bronchoalveolar lavage fluid samples for pulmonary tuberculosis diagnosis.Respiratory research & clinical practice · 2026Article
- Sociodemographic and Clinical Factors Associated with Tuberculosis Mortality in Hamadan Province, Iran.Journal of research in health sciences · 2025Article
- Article
- Factors associated with tuberculosis treatment initiation among bacteriologically negative individuals evaluated for tuberculosis: an individual patient data meta-analysis.medRxiv : the preprint server for health sciences · 2024Article
- The effect of empirical and laboratory-confirmed tuberculosis on treatment outcomes.Scientific reports · 2021Article
- Chest X-ray interpretation does not complement Xpert MTB/RIF in diagnosis of smear-negative pulmonary tuberculosis among TB-HIV co-infected adults in a resource-limited setting.BMC infectious diseases · 2021Article
- Methodological considerations in establishing and maintaining longitudinal health workforce studies: Lessons learned from the WiSDOM cohort in South Africa.Global health action · 2021Article
- HIV testing uptake and HIV positivity among presumptive tuberculosis patients in Mandalay, Myanmar, 2014-2017.PloS one · 2020Article
- Mortality Among People With HIV Treated for Tuberculosis Based on Positive, Negative, or No Bacteriologic Test Results for Tuberculosis: The IeDEA Consortium.Open forum infectious diseases · 2020Article
- Prevalence of tuberculosis, multidrug resistant tuberculosis and associated risk factors among smear negative presumptive pulmonary tuberculosis patients in Addis Ababa, Ethiopia.BMC infectious diseases · 2019Article
- An Observational Case-Control Study to Determine Human Immunodeficiency Virus and Host Factor Influence on Biomarker Distribution and Serodiagnostic Potential in Adult Pulmonary Tuberculosis.Tropical medicine and infectious disease · 2019Article
- Time delay and associated mortality from negative smear to positive Xpert MTB/RIF test among TB/HIV patients: a retrospective study.BMC infectious diseases · 2019Article
- False rifampicin resistant results using Xpert MTB/RIF on urine samples in hospitalised HIV-infected patients.Southern African journal of HIV medicine · 2019Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
objectiveTo investigate mortality rates and risk factors for death among smear-negative tuberculosis (TB) suspects.
designCohort study nested within a cluster-randomised trial of community-based active case finding. Smear-negative TB suspects were followed for 12 months, with home tracing where necessary. We calculated mortality rates and used regression analysis to investigate the relationship between clinical characteristics and death.
resultsBetween February 2006 and June 2007, 1195 smear-negative TB suspects were followed for 1136.8 person-years. Human immunodeficiency virus (HIV) prevalence was 63.3%. During follow-up, 139 participants died (11.6%) and mortality rates remained high throughout; 119 (16.5%) HIV-positive individuals and 13 (3.1%) HIV-negative individuals died (HR = 5.8, 95%CI 3.3-10.4, P < 0.001). Advanced immunosuppression was the main risk factor for death among HIV-positive participants, with CD4 count < 50 cells/μ l associated with a 13-fold increased risk of death. Antiretroviral treatment (ART) was initiated by only 106 (14.7%), with long delays in accessing care.
conclusionHIV-positive smear-negative TB suspects are at high and sustained risk of death. Current guidelines for the management of HIV-infected TB suspects are limited, and this study adds to evidence that specific policies are required to promote earlier HIV and TB diagnosis and reduce delays in ART initiation.
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