ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Tuberculosis in Hospitalized Patients With Human Immunodeficiency Virus: Clinical Characteristics, Mortality, and Implications From the Rapid Urine-based Screening for Tuberculosis to Reduce AIDS Related Mortality in Hospitalized Patients in Africa.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Cause of Death and Risk of Death for People Living With HIV Admitted to Hospital: A Systematic Review and Meta-Analysis.Journal of the International AIDS Society · 2026Pooled it
- A systematic review of the quality of conduct and reporting of survival analyses of tuberculosis outcomes in Africa.BMC medical research methodology · 2021Pooled it
- Determinants of tuberculosis presentation and successful treatment outcome among tuberculosis patients in Geita, Tanzania.PloS one · 2026Article
- Social and Structural Interventions to Reduce Strikingly High Post-Hospital Mortality for People Living with HIV in Sub-Saharan Africa.Current HIV/AIDS reports · 2025Review
- Cerebral Perfusion Pressures and Implications on Clinical Outcomes and Medical Management in Cryptococcal Meningitis.Open forum infectious diseases · 2025Article
- Blood and urine early treatment response biomarkers in HIV-associated disseminated tuberculosis.Southern African journal of HIV medicine · 2025Article
- A predictive score for early in-patient tuberculosis mortality: A case-control study.Journal of clinical tuberculosis and other mycobacterial diseases · 2024Article
- Mid-Upper Arm Circumference Is a Strong Predictor of Mortality Among Ugandan Adults With HIV-Associated Cryptococcal Meningitis: A Prospective Cohort Study.Open forum infectious diseases · 2024Article
- TB diagnoses and mortality in hospitalized people living with HIV in South Africa.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2024Article
- Mortality among extrapulmonary tuberculosis patients in the HIV endemic setting: lessons from a tertiary level hospital in Mbeya, Tanzania.Scientific reports · 2024Article
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- Urine Lipoarabinomannan Testing in Adults With Advanced Human Immunodeficiency Virus in a Trial of Empiric Tuberculosis Therapy.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
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- Health behavior and social crisis in the era of COVID-19 in Malawi: A decolonizing approach to a qualitative study.Nursing outlookArticle
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11 authors at 6 institutions in 3 countries.
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Abstract
backgroundTuberculosis (TB) is the major killer of people living with human immunodeficiency virus (HIV) globally, with suboptimal diagnostics and management contributing to high case-fatality rates.
methodsA prospective cohort of patients with confirmed TB (Xpert MTB/RIF and/or Determine TB-LAM Ag positive) identified through screening HIV-positive inpatients with sputum and urine diagnostics in Malawi and South Africa (Rapid urine-based Screening for Tuberculosis to reduce AIDS Related Mortality in hospitalized Patients in Africa [STAMP] trial). Urine was tested prospectively (intervention) or retrospectively (standard of care arm). We defined baseline clinical phenotypes using hierarchical cluster analysis, and also used Cox regression analysis to identify associations with early mortality (≤56 days).
resultsOf 322 patients with TB confirmed between October 2015 and September 2018, 78.0% had ≥1 positive urine test. Antiretroviral therapy (ART) coverage was 80.2% among those not newly diagnosed, but with median CD4 count 75 cells/µL and high HIV viral loads. Early mortality was 30.7% (99/322), despite near-universal prompt TB treatment. Older age, male sex, ART before admission, poor nutritional status, lower hemoglobin, and positive urine tests (TB-LAM and/or Xpert MTB/RIF) were associated with increased mortality in multivariate analyses. Cluster analysis (on baseline variables) defined 4 patient subgroups with early mortality ranging from 9.8% to 52.5%. Although unadjusted mortality was 9.3% lower in South Africa than Malawi, in adjusted models mortality was similar in both countries (hazard ratio, 0.9; P = .729).
conclusionsMortality following prompt inpatient diagnosis of HIV-associated TB remained unacceptably high, even in South Africa. Intensified management strategies are urgently needed, for which prognostic indicators could potentially guide both development and subsequent use.
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