• 1.

    World Health Organization, 2015. World Health Organization Country Fact Sheet, Tuberculosis, Tanzania, 2015. Geneva, Switzerland: World Health Organization. Available at: http://www.who.int/tb/country/data/profiles/en/. Accessed March 31, 2015.

    • Search Google Scholar
    • Export Citation
  • 2.

    Peloquin CA, Berning SE, Nitta AT, Simone PM, Goble M, Huitt GA, Iseman MD, Cook JL, Curran-Everett D, 2004. Aminoglycoside toxicity: daily versus thrice-weekly dosing for treatment of mycobacterial diseases. Clin Infect Dis 38: 15381544.

    • Search Google Scholar
    • Export Citation
  • 3.

    Bratviet M, Moen BE, Mashalla YJS, Maalim H, 2003. Dust exposure during small-scale mining in Tanzania: a pilot study. Ann Occup Hyg 47: 235240.

    • Search Google Scholar
    • Export Citation
  • 4.

    Rees D, Murrary J, 2007. Silica, silicosis and tuberculosis. Int J Tuberc Lung Dis 11: 474484.

  • 5.

    United Republic of Tanzania: Ministry of Health and Social Welfare (MoH and SW), 2006. National TB and Leprosy Program, Clinical Guideline for TB Management. Dar es Salaam, United Republic of Tanzania: MoH and SW.

    • Search Google Scholar
    • Export Citation
  • 6.

    Mpagama S, Heysell SK, Ndusilo ND, Kumburu HH, Lekule IA, Kisonga RM, Gratz J, Boeree MJ, Houpt ER, Kibiki GS, 2013. Diagnosis and interim treatment outcomes from the first cohort of multidrug-resistant tuberculosis patients in Tanzania. PLoS One 8: e62034.

    • Search Google Scholar
    • Export Citation
  • 7.

    Burton NT, Forson A, Lurie MN, Kudzawa S, Kwarteng E, Kwara A, 2011. Factors associated with mortality and default among patients with tuberculosis attending a teaching hospital clinic in Accra, Ghana. Trans R Soc Trop Med Hyg 105: 675682.

    • Search Google Scholar
    • Export Citation
  • 8.

    Heysell SK, Mtabho C, Mpagama S, Mwaigwisya S, Ndusilo N, Pholwat S, Gratz J, Aarnouste R, Kibiki GS, Houpt ER, 2011. A plasma drug activity assay for treatment optimization in tuberculosis patients. Antimicrob Agents Chemother 55: 58195825.

    • Search Google Scholar
    • Export Citation
  • 9.

    Tostmann A, Mtabho CM, Semvua HH, van den Boogaard J, Kibiki GS, Boeree MJ, Aarnoutse RE, 2013. Pharmacokinetics of first-line tuberculosis drugs in Tanzanian patients. Antimicrob Agents Chemother 57: 32083213.

    • Search Google Scholar
    • Export Citation
  • 10.

    Hoa NB, Lauritsen JM, Rieder HL, 2013. Changes in body weight and tuberculosis treatment outcome in Viet Nam. Int J Tuberc Lung Dis 17: 6166.

    • Search Google Scholar
    • Export Citation
  • 11.

    Barroso EC, Pinheiro VGF, Facanha MC, Carvalho MRD, Moura ME, Campelo CL, Peloquin CA, Guerrant RL, Lima AAM, 2009. Serum concentrations of rifampin, isoniazid and intestinal absorption, permeability in patients with multidrug resistant tuberculosis. Am J Trop Med Hyg 81: 322329.

    • Search Google Scholar
    • Export Citation
  • 12.

    van Ingen J, Aarnoutse RE, Donald PR, Diacon AH, Dawson R, van Balen GP, Gillespie SH, Boeree MJ, 2011. Why do we use 600 mg of rifampicin in tuberculosis treatment? Clin Infect Dis 52: e194e199.

    • Search Google Scholar
    • Export Citation
  • 13.

    Reynolds J, Heysell SK, 2014. Understanding pharmacokinetics to improve tuberculosis treatment outcome. Expert Opin Drug Metab Toxicol 10: 813823.

    • Search Google Scholar
    • Export Citation
  • 14.

    Jacob ST, Banura P, Baeten JM, Moore CC, Meya D, Nakiyingi L, Burke R, Horton CL, Iga B, Wald A, Reynolds SJ, Mayanja-Kizza H, Scheld WM, 2012. The impact of early monitored management on survival in hospitalized adult Ugandan patients with severe sepsis: a prospective intervention study. Crit Care Med 40: 20502058.

    • Search Google Scholar
    • Export Citation
  • 15.

    Heysell SK, Thomas TA, Moll AP, Gandhi NR, Eksteen FJ, Babaria P, Roux L, Coovadia Y, Lallo U, Friedland G, Shah NS, 2010. Blood cultures for the diagnosis of multidrug-resistant and extensively drug-resistant tuberculosis among HIV-infected patients from rural South Africa. BMC Infect Dis 10: 344.

    • Search Google Scholar
    • Export Citation
  • 16.

    TB CARE I, 2014. International Standards for Tuberculosis Care, 3rd edition. The Hague, The Netherlands: TB CARE I.

  • 17.

    Srivastava S, Pasipanodya JG, Meek C, Leff R, Gumbo T, 2011. Multidrug-resistant tuberculosis not due to noncompliance but to between-patient pharmacokinetic variability. J Infect Dis 204: 19511959.

    • Search Google Scholar
    • Export Citation
  • 18.

    Stuckler D, Basu S, McKee M, Lurie M, 2011. Mining and risk of tuberculosis in sub-Saharan Africa. Am J Public Health 101: 524530.

  • 19.

    Hnizdo E, Murray J, 1998. Risk of pulmonary tuberculosis relative to silicosis and exposure to silica dust in South African gold miners. Occup Environ Med 55: 496502.

    • Search Google Scholar
    • Export Citation
  • 20.

    Churchyard G, Kleinschmidt I, Corbett EL, Murray J, Smit J, De Cock KM, 2000. Factors associated with an increased case-fatality rate in HIV-infected and non-infected South African gold miners with pulmonary tuberculosis. Int J Tuberc Lung Dis 4: 705712.

    • Search Google Scholar
    • Export Citation
  • 21.

    Basu S, Stuckler D, McKee M, 2011. Addressing institutional amplifiers in the dynamics and control of tuberculosis epidemics. Am J Trop Med Hyg 84: 3037.

    • Search Google Scholar
    • Export Citation

 

 

 

 

The Influence of Mining and Human Immunodeficiency Virus Infection Among Patients Admitted for Retreatment of Tuberculosis in Northern Tanzania

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  • Kibong'oto Infectious Disease Hospital, Kilimanjaro, United Republic of Tanzania; Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, Virginia

In tuberculosis (TB)–prevalent settings, patients admitted for retreatment of TB may account for a high burden of poor treatment outcome. We performed a retrospective cohort study to characterize retreatment patients and outcomes at a TB referral hospital in northern Tanzania. From 2009 to 2013, 185 patients began a retreatment regimen, the majority for relapse after prior treatment completion. Men accounted for an unexpected majority (88%), 36 (20%) were human immunodeficiency virus (HIV) infected and for 45 (24%) mining was their primary occupation. A poor outcome (death, default, or persistent smear positivity after 7 months of treatment) was found in 37 (23%). HIV infection was the only significant predictor of poor outcome (adjusted odds ratio [aOR] = 2.50, 95% confidence interval [CI] = 1.07–5.83, P = 0.034). Interventions to minimize need for retreatment or improve retreatment success may be regionally specific. In our setting, community-based diagnosis and management among at-risk subpopulations such as miners and those HIV infected appear of highest yield.

Author Notes

* Address correspondence to Scott K. Heysell, Division of Infectious Diseases and International Health, University of Virginia, P.O. Box 81340, Charlottesville, VA 22908. E-mail: skh8r@virginia.edu

Authors' addresses: Stellah G. Mpagama, Isaack A. Lekule, Alexander W. Mbuya, and Riziki M. Kisonga, Department of Tuberculosis, Kibong'oto Infectious Diseases Hospital, Kilimanjaro, United Republic of Tanzania, E-mails: sempagama@yahoo.com, lekule228@gmail.com, kiletsa@hotmail.com, and kisonga2002@yahoo.com. Scott K. Heysell, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, E-mail: scott.heysell@gmail.com.

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