Predictors and short-term outcomes of recurrent pulmonary tuberculosis, Uganda: a cohort study

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dc.contributor.authorKalema, Nelson
dc.contributor.authorLindan, Christina
dc.contributor.authorGlidden, Dave
dc.contributor.authorYoo, Samuel D.
dc.contributor.authoratamba, Achilles K
dc.contributor.authorAlfred, Andama
dc.contributor.authorKatagira, Winceslaus
dc.contributor.authorByanyima, Patrick
dc.contributor.authorMusisi, Emmanuel
dc.contributor.authorKaswabuli, Sylvia
dc.contributor.authorIngvar, Sanyu
dc.contributor.authorZawedde, Josephine
dc.contributor.authorYoon, Christina
dc.contributor.authorAyakaka, Irene
dc.contributor.authorLucian Davis, J.
dc.contributor.authorHuang, Laurence
dc.contributor.authorWorodria, William
dc.contributor.authorCattamanchi, Adithya
dc.date.accessioned2023-01-18T19:17:19Z
dc.date.available2023-01-18T19:17:19Z
dc.date.issued2017
dc.description.abstractRecurrent tuberculosis (TB) occurring >2 years after completing treatment for a prior TB episode is most often due to reinfection with a new strain of M. tuberculosis. Objectives—We determined the prevalence and outcome of late recurrent TB among hospitalized patients in Kampala, Uganda. Methods—We conducted a retrospective analysis of patients admitted to Mulago Hospital who had cough of >2 weeks’ duration and completed TB treatment >2 years prior to admission. All patients had mycobacterial culture performed on two sputum specimens and vital status ascertained 2-months post-enrollment. We performed logistic regression and Cox proportional hazards modelling to identify predictors of recurrent TB and survival, respectively. Results—Among 234 patients, 84 (36%) had recurrent TB. Independent predictors included younger age (aOR=0.64, 95% CI=0.42-0.97, p=0.04), chest pain >2 weeks (aOR=3.32, 95% CI=1.38-8.02, p=0.007), severe weight loss ≥5 kilograms (aOR=4.88, 95% CI=1.66-14.29, p=0.004) and presence of ≥1 WHO danger sign of severe illness (aOR=3.55, 95% CI=1.36-9.29, p=0.01). Two-month mortality was 17.8% (95% CI=10.5-29.2%), and was higher among patients who were not initiated on TB treatment (aHR=16.67, 95% CI=1.18-200, p=0.04), those who were HIV-positive and not on antiretroviral treatment (aHR=16.99, 95% CI=1.17-246.47, p=0.04) and those with a history of smoking (aHR=1.20, 95% CI=1.03-1.40, p=0.02). Conclusion—The high prevalence of late recurrent TB likely reflects high levels of TB transmission in Kampala. Increased use of empiric TB treatment and early ART treatment initiation if HIV-positive should be considered in patients with a prior history of TB, particularly if they are young, with weight loss ≥5kgs, chest pain >2 weeks or ≥1 WHO danger sign of severe illness.en_US
dc.identifier.citationKalema, N., Lindan, C., Glidden, D., Yoo, S. D., Katamba, A., Alfred, A., ... & Cattamanchi, A. (2017). Predictors and short-term outcomes of recurrent pulmonary tuberculosis, Uganda: a cohort study. South African respiratory journal, 23(4), 106.en_US
dc.identifier.urihttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5777612/
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/7063
dc.language.isoenen_US
dc.publisherSouth African respiratory journalen_US
dc.subjectRecurrent TBen_US
dc.subjectSurvivalen_US
dc.subjectTreatmenten_US
dc.titlePredictors and short-term outcomes of recurrent pulmonary tuberculosis, Uganda: a cohort studyen_US
dc.typeArticleen_US
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