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

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

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

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

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

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

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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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