ArticleThe Journal of infectious diseases2026
Risk Factors for Immunological Sensitization to Mycobacterium tuberculosis and Progression to Incident TB Disease Among HIV-uninfected Adults in a High Burden Setting.
Article in The Journal of infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Risk of progression to pulmonary tuberculosis among household contacts with chest radiographic abnormalities in South Africa.medRxiv : the preprint server for health sciences · 2026Article
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11 authors.
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Abstract
backgroundIdentifying risk factors for Mycobacterium tuberculosis (Mtb) sensitization (defined as interferon-gamma release assays [IGRA]-positive) and progression to tuberculosis (TB) disease is critical to guide targeted prevention strategies.
methodsWe analyzed data from a prospective cohort of adults (18-60 years) without HIV, enrolled at five high-incidence South African sites. Participants underwent testing for Mtb sensitization and microbiologically confirmed TB at baseline, and during 15 months follow-up. Multivariable logistic and Cox regression models were used to assess factors associated with Mtb sensitization and TB progression. Sampling weights were applied to reflect the screened population.
resultsAmong 2912 participants with valid IGRA results, 63.4% (n = 1895) were Mtb-sensitized. Prevalent TB was detected in 1.81% (62/1895) of Mtb-sensitized vs 0.62% (12/1017) of Mtb-unsensitized individuals (P = .01). During follow-up of participants without prevalent TB, 2.01% (48/1833) Mtb-sensitized and 0.53% (8/1005) Mtb-unsensitized individuals developed TB (P = .01). Factors associated with Mtb sensitization included increasing age (adjusted odds ratio [aOR] = 1.02, 95% CI 1.01-1.03), male sex (aOR = 1.34, 95% CI 1.08-1.67), smoking (aOR = 1.31, 95% CI 1.05-1.64), prior TB (aOR = 2.20, 95% CI 1.40-3.47), and TB contact history (aOR = 1.40, 95% CI 1.08-1.83). Risk factors for progression to TB were Mtb sensitization (adjusted hazard ratio [aHR] = 3.05, 95% CI 1.14-8.18), smoking history (aHR = 2.34, 95% CI 1.03-5.31), and lower body mass index (BMI) (aHR = 0.89, 95% CI .82-.97).
conclusionsMtb-sensitized individuals had a 3-fold higher risk of prevalent TB and progressing to TB compared to Mtb-unsensitized individuals. In high-prevalence settings, identifying individuals at greatest risk-such as those recently infected, with a history of smoking, or low BMI-could help refine TB prevention efforts and reduce community-level transmission.
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