Evidence map›Paper›PMID 36260441›Full record

ArticleInternational journal of mycobacteriology

Multiple pathogens contribute to human immunodeficiency virus-related sepsis in addition to

Donatus Bonphace Tsere, Gabriel Mkilema Shirima, Brian S Grundy, Scott K Heysell, Stellah G Mpagama, Shabani Ramadhani Mziray, Peter M Mbelele

Open access · diamondAbstract read
In one paragraph

Article in International journal of mycobacteriology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 49% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
  2. Lateral flow urine lipoarabinomannan assay for tuberculosis diagnosis in HIV-positive inpatients and outpatients.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Donatus Bonphace TsereDepartment of medical services, Kibong'oto Infectious Diseases Hospital, Siha; Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania.
Gabriel Mkilema ShirimaDepartment of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania.
Brian S GrundyDivision of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA.
Scott K HeysellDivision of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia, USA.
Stellah G MpagamaDepartment of medical services, Kibong'oto Infectious Diseases Hospital, Siha, Tanzania.
Shabani Ramadhani MzirayDepartment of medical services, Kibong'oto Infectious Diseases Hospital, Siha; Department of Biochemistry and Molecular Biology, Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania.
Peter M MbeleleDepartment of medical services, Kibong'oto Infectious Diseases Hospital, Siha; Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania.
Nelson Mandela African Institution of Science and Technology · TZUniversity of Virginia · USKilimanjaro Christian Medical Centre · TZ

Funding

INFECTIOUS DISEASES TRAINING PROGRAMT32AI007046 · NIAID · UNIVERSITY OF VIRGINIA CHARLOTTESVILLE · PI Alison K Criss, William A Petri · 1985 to 2026
$15.3M
A randomized clinical trial of early empiric anti-Mycobacterium tuberculosis therapy for sepsis in sub-Saharan AfricaU01AI150508 · NIAID · UNIVERSITY OF VIRGINIA · PI HEYSELL, SCOTT K, MOORE, CHRISTOPHER CHARLES · 2020 to 2024
$3.3M
EPA EP-C-15-008NIAID NIH HHS T32 AI007046NIAID NIH HHS U01 AI150508Wellcome TrustWellcome Trust 107753/A/15/Z
6 · The paper itself

Abstract

Background: Mortality from tuberculosis (TB) sepsis is common among patients living with human immunodeficiency virus (PLHIV). We aimed to detect M. tuberculosis (MTB) and additional sepsis etiologies, and mortality determinants in PLHIV. Methods: This prospective cohort study consented and followed-up PLHIV for 28 days in northern Tanzania. From May through December 2021, patients provided urine and sputum for TB testing in lateral-flow lipoarabinomannan (LF-LAM) and Xpert® MTB/RIF. Bacterial blood culture, cryptococcal antigen, malaria rapid diagnostic, C-reactive-protein (CRP), and international normalized ratio (INR) tests were also performed. Sepsis severity was clinically measured by Karnofsky and modified early warning signs (MEWS) scores. Anti-TB, broad-spectrum antibiotics, and antimalarial and antifungal agents were prescribed in accordance with Tanzania treatment guideline. An independent t-test and Chi-square or Fisher's exact tests compared means and proportions, respectively. P < 0.05 was statistically significant. Results: Among 98 patients, 59 (60.2%) were female. Their mean (standard deviation) age was 44 (12.9) years. TB detection increased from 24 (24.5%) by Xpert® MTB/RIF to 36 (36.7%) when LF-LAM was added. In total, 23 (23.5%) patients had other than TB etiologies of sepsis, including Staphylococcus aureus, Streptococcus pneumoniae, Cryptococcus spp., and Plasmodium spp. Twenty-four (94.4%) of 36 patients with TB had higher CRP (≥10 mg/l) compared to 25 (40.3%) non-TB patients (P < 0.001). Nine (9.2%) patients died and almost all had INR ≥1.8 (n = 8), Karnofsky score <50% (n = 9), MEWS score >6 (n = 8), and malnutrition (n = 9). Conclusions: MTB and other microbes contributed to sepsis in PLHIV. Adding non-TB tests informed clinical decisions. Mortality was predicted by conventional sepsis and severity scoring, malnutrition, and elevated INR.

Indexed as

AntimalarialsHIV InfectionsMalnutritionMycobacterium tuberculosisSepsisTuberculosis, Lymph NodeAdultAnti-Bacterial AgentsAntifungal AgentsCohort StudiesFemaleHIVHumansMaleProspective StudiesTanzaniaAnti-Bacterial AgentsAntifungal AgentsAntimalarialsBlood cultureetiologies of sepsismortalitypeople living with human immunodeficiency virustuberculosis

Identifiers

PMID36260441
PMCPMC9582297
OpenAlexW4295231800

What OpenQuestion holds

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LicenceCC BY-SA
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.