Observational studyBMC infectious diseases2019
Urban-rural disparities in treatment outcomes among recurrent TB cases in Southern Province, Zambia.
Observational study in BMC infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.
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Who cites it
28 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Antimicrobial resistance from a One Health perspective in Zambia: a systematic review.Antimicrobial resistance and infection control · 2023Pooled it
- Pooled it
- Pooled it
- One dollar incentive improves tuberculosis treatment outcomes in programmatic settings in rural Uganda.Scientific reports · 2021Trial
- Prevalence and factors associated with tuberculosis recurrence among key vulnerable populations in the Ashanti region, Ghana.BMC infectious diseases · 2026Article
- Factors Influencing Tuberculosis Treatment Outcomes in Lalitpur District, Nepal: A Retrospective Cohort Study.Journal of epidemiology and global health · 2026Article
- Risk factors and treatment outcomes of drug-resistant tuberculosis among patients attending Ndola Teaching Hospital, Zambia: a retrospective case-control study.The Pan African medical journal · 2026Article
- Predictors of tuberculosis mortality among patients on treatment: A retrospective cohort study at a rural general hospital in Zambia.PloS one · 2026Article
- Magnitude of poor multidrug-resistant tuberculosis treatment outcome among multidrug-resistant tuberculous patients at tertiary hospital, South West Ethiopia.Annals of clinical microbiology and antimicrobials · 2025Article
- Epidemiological, Socioeconomic, and Health Service Factors Associated with Tuberculosis Treatment Interruption in Brazil.Epidemiologia (Basel, Switzerland) · 2025Article
- Determinants of Tuberculosis Treatment Outcomes in Patients with TB/HIV Co-Infection During Tuberculosis Treatment at Selected Level One Hospitals in Lusaka, Zambia.Antibiotics (Basel, Switzerland) · 2025Article
- Innovative timing strategies for tuberculosis household contact investigation: cost-effectiveness analysis from a randomized trial in rural and urban South Africa (Kharituwe Study).EClinicalMedicine · 2025Article
- Time to reoccurrence of tuberculosis and its predictors among adult HIV/AIDS patients on ART at public hospitals in East and Horro Guduru Wollega zones, West Ethiopia: a retrospective cohort study.BMC public health · 2025Article
- High mortality among patients with tuberculosis accessing primary care facilities: secondary analysis from an open-label cluster-randomised trial.EClinicalMedicine · 2025Article
- Health worker perspectives on barriers and facilitators of tuberculosis investigation coverage among index case contacts in rural Southwestern Uganda: a qualitative study.BMC infectious diseases · 2024Article
- Timing and predictors of death during treatment in patients with multidrug/rifampin-resistant tuberculosis in South Korea.The Korean journal of internal medicine · 2024Article
- Article
- Increased active pulmonary tuberculosis risk from sharing bong of cannabis: a case-control study from Thailand.Frontiers in public health · 2024Article
- Mortality among persons with tuberculosis in Zambian hospitals: A retrospective cohort study.PLOS global public health · 2024Article
- Heterogeneity of Mycobacterium tuberculosis Strains Circulating in Panama's Western Region.The American journal of tropical medicine and hygiene · 2023Article
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Authors and funding
9 authors.
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Abstract
backgroundAt least 13-20% of all Tuberculosis (TB) cases are recurrent TB. Recurrent TB has critical public health importance because recurrent TB patients have high risk of Multi-Drug Resistant TB (MDR-TB). It is critical to understand variations in the prevalence and treatment outcomes of recurrent TB between different geographical settings. The objective of our study was to estimate the prevalence of recurrent TB among TB cases and compare risk of unfavorable treatment outcomes between rural and urban settings.
methodsIn a retrospective cohort study conducted in southern province of Zambia, we used mixed effects logistic regression to asses associations between explanatory and outcome variables. Primary outcome was all-cause mortality and exposure was setting (rural/urban). Data was abstracted from the facility TB registers.
resultsOverall 3566 recurrent TB cases were diagnosed among 25,533 TB patients. The prevalence of recurrent TB was 15.3% (95% CI: 14.8 15.9) in urban and 11.3% (95% CI: 10.7 12.0) in rural areas. Death occurred in 197 (5.5%), 103 (2.9%) were lost to follow-up, and 113 (3.2%) failed treatment. Rural settings had 70% higher risk of death (adjusted OR: 1.7; 95% CI: 1.2 2.7). Risk of lost to follow-up was twice higher in rural than urban (adjusted OR: 2.0 95% CI: 1.3 3.0). Compared to HIV-uninfected, HIV-infected individuals on Antiretroviral Treatment (ART) were 70% more likely to die (adjusted OR: 1.7; 95% CI: 1.2 3.1).
conclusionRecurrent TB prevalence was generally high in both urban and rural settings. The risk of mortality and lost to follow-up was higher among rural patients. We recommend a well-organized Directly Observed Therapy strategy adapted to setting where heightened TB control activities are focused on areas with poor treatment outcomes.
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