ArticlePLOS global public health2023
Prevalence of bacteriologically-confirmed pulmonary tuberculosis in urban Blantyre, Malawi 2019-20: Substantial decline compared to 2013-14 national survey.
Article in PLOS global public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Differences in tuberculosis prevalence by sex in low- and middle-income countries over 1993-2025: A systematic review and meta-analysis.PLoS medicine · 2026Pooled it
- Drivers of sex differences in Mycobacterium tuberculosis immunoreactivity among adolescents and adults in Blantyre, Malawi.BMC global and public health · 2026Article
- Article
- Genomic epidemiology ofMicrobial genomics · 2026Article
- Perceived gender equitable norms and previous tuberculosis testing in Malawi: A secondary analysis of a cluster-based prevalence survey.PLOS global public health · 2026Article
- Quantifying excess TB prevalence among people living with HIV on ART in the universal ART era: Evidence from a TB prevalence survey in Zambia and South Africa.PLOS global public health · 2026Article
- Environmental hazards from pollution of antibiotics and resistance-driving chemicals in an urban river network from Malawi.npj antimicrobials and resistance · 2025Article
- Towards TB elimination in Malawi: a 5-year analysis of key indicators for TB control using surveillance data.IJTLD open · 2025Article
- Reductions in development assistance for health funding threaten decades of progress in Africa.PLoS medicine · 2025Article
- Post-tuberculosis lung disease: towards prevention, diagnosis, and care.The Lancet. Respiratory medicine · 2025Review
- Low concordance between QIAreach QuantiFERON-TB, a novel interferon-gamma release assay, and QuantiFERON-TB Gold Plus, in a population-based survey in Blantyre, Malawi.Journal of clinical microbiology · 2025Article
- Barriers to GeneXpert utilization for tuberculosis detection at a regional referral hospital in Malawi: a qualitative study.The Pan African medical journal · 2025Article
- Persistently high TB prevalence in Nairobi County neighbourhoods, 2015-2022.PLOS global public health · 2025Article
- Community-based active-case finding for tuberculosis: navigating a complex minefield.BMC global and public health · 2024Review
- Respiratory symptoms after TB treatment completion: A qualitative study of patient and provider experiences in urban Blantyre, Malawi.PLOS global public health · 2024Article
- Treatment preferences among people at risk of developing tuberculosis: A discrete choice experiment.PLOS global public health · 2024Article
- Article
- Article
- Impact of active case-finding for tuberculosis on case-notifications in Blantyre, Malawi: A community-based cluster-randomised trial (SCALE).PLOS global public health · 2023Article
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Authors and funding
14 authors at 4 institutions in 2 countries.
Funding
Abstract
Recent evidence shows rapidly changing tuberculosis (TB) epidemiology in Southern and Eastern Africa, with need for subdistrict prevalence estimates to guide targeted interventions. We conducted a pulmonary TB prevalence survey to estimate current TB burden in Blantyre city, Malawi. From May 2019 to March 2020, 115 households in middle/high-density residential Blantyre, were randomly-selected from each of 72 clusters. Consenting eligible participants (household residents ≥ 18 years) were interviewed, including for cough (any duration), and offered HIV testing and chest X-ray; participants with cough and/or abnormal X-ray provided two sputum samples for microscopy, Xpert MTB/Rif and mycobacterial culture. TB disease prevalence and risk factors for prevalent TB were calculated using complete-case analysis, multiple imputation, and inverse probability weighting. Of 20,899 eligible adults, 15,897 (76%) were interviewed, 13,490/15,897 (85%) had X-ray, and 1,120/1,394 (80%) sputum-eligible participants produced at least one specimen, giving 15,318 complete cases (5,895, 38% men). 29/15,318 had bacteriologically-confirmed TB (189 per 100,000 complete-case (cc) / 150 per 100,000 with inverse weighting (iw)). Men had higher burden (cc: 305 [95% CI:144-645] per 100,000) than women (cc: 117 [95% CI:65-211] per 100,000): cc adjusted odds ratio (aOR) 2.70 (1.26-5.78). Other significant risk factors for prevalent TB on complete-case analysis were working age (25-49 years) and previous TB treatment, but not HIV status. Multivariable analysis of imputed data was limited by small numbers, but previous TB and age group 25-49 years remained significantly associated with higher TB prevalence. Pulmonary TB prevalence for Blantyre was considerably lower than the 1,014 per 100,000 for urban Malawi in the 2013-14 national survey, at 150-189 per 100,000 adults, but some groups, notably men, remain disproportionately affected. TB case-finding is still needed for TB elimination in Blantyre, and similar urban centres, but should focus on reaching the highest risk groups, such as older men.
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