ArticleScientific reports2019
Space-time clustering of recently-diagnosed tuberculosis and impact of ART scale-up: Evidence from an HIV hyper-endemic rural South African population.
Article in Scientific reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Trial
- A retrospective analysis of tuberculosis notification trends and spatial distribution in South Africa, 2005-2012.Discover public health · 2026Article
- Article
- Geospatial Distribution of Tuberculosis Incidence and Determinants of Tuberculosis Treatment Outcomes in Nzema East Municipality, Ghana.Public health challenges · 2025Article
- Impact of increasing CD4 count threshold eligibility for antiretroviral therapy initiation on advanced HIV disease and tuberculosis prevalence and incidence in South Africa: an interrupted time series analysis.BMJ global health · 2025Article
- Tuberculin skin test surveys and the Annual Risk of Tuberculous Infection in school children in Northern KwaZulu-Natal.PLOS global public health · 2024Article
- Prevalence of Mycobacterium tuberculosis in Sputum and Reported Symptoms Among Clinic Attendees Compared With a Community Survey in Rural South Africa.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Review
- GeneXpert rollout in three high-burden tuberculosis countries in Africa: A review of pulmonary tuberculosis diagnosis and outcomes from 2001 to 2019.African journal of laboratory medicine · 2022Article
- Cohort Profile Update: Africa Centre Demographic Information System (ACDIS) and population-based HIV survey.International journal of epidemiology · 2021Article
- Prevalence and Risk Factors forOpen forum infectious diseases · 2021Article
- Exposure to waste sites and their impact on health: a panel and geospatial analysis of nationally representative data from South Africa, 2008-2015.The Lancet. Planetary health · 2020Article
- Opportunities and Challenges in HIV Treatment as Prevention Research: Results from the ANRS 12249 Cluster-Randomized Trial and Associated Population Cohort.Current HIV/AIDS reports · 2020Review
- An Inflammatory Story: Antibodies in Tuberculosis Comorbidities.Frontiers in immunology · 2019Review
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Authors and funding
7 authors.
Funding
Abstract
In HIV hyperendemic sub-Saharan African communities, particularly in southern Africa, the likelihood of achieving the Sustainable Development Goal of ending the tuberculosis (TB) epidemic by 2030 is low, due to lack of cost-effective and practical interventions in population settings. We used one of Africa's largest population-based prospective cohorts from rural KwaZulu-Natal Province, South Africa, to measure the spatial variations in the prevalence of recently-diagnosed TB disease, and to quantify the impact of community coverage of antiretroviral therapy (ART) on recently-diagnosed TB disease. We collected data on TB disease episodes from a population-based sample of 41,812 adult individuals between 2009 and 2015. Spatial clusters ('hotspots') of recently-diagnosed TB were identified using a space-time scan statistic. Multilevel logistic regression models were fitted to investigate the relationship between community ART coverage and recently-diagnosed TB. Spatial clusters of recently-diagnosed TB were identified in a region characterized by a high prevalence of HIV and population movement. Every percentage increase in ART coverage was associated with a 2% decrease in the odds of recently-diagnosed TB (aOR = 0.98, 95% CI:0.97-0.99). We identified for the first time the clear occurrence of recently-diagnosed TB hotspots, and quantified potential benefit of increased community ART coverage in lowering tuberculosis, highlighting the need to prioritize the expansion of such effective population interventions targeting high-risk areas.
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