TB Group, Population Health Program, Texas Biomedical Research Institute, San Antonio, TX, USA.
Centro de Investigação em Saude de Manhiça (CISM), Maputo, Mozambique.
Sci Rep. 2020 Sep 22;10(1):15442. doi: 10.1038/s41598-020-71784-3.
Tuberculosis (TB) misdiagnosis remains a public health concern, especially among people living with HIV (PLHIV), given the high mortality associated with missed TB diagnoses. The main objective of this study was to describe the all-cause mortality, TB incidence rates and their associated risk factors in a cohort of PLHIV with presumptive TB in whom TB was initially ruled out. We retrospectively followed a cohort of PLHIV with presumptive TB over a 2 year-period in a rural district in Southern Mozambique. During the study period 382 PLHIV were followed-up. Mortality rate was 6.8/100 person-years (PYs) (95% CI 5.2-9.2) and TB incidence rate was 5.4/100 PYs (95% CI 3.9-7.5). Thirty-six percent of deaths and 43% of TB incident cases occurred in the first 12 months of the follow up. Mortality and TB incidence rates in the 2-year period after TB was initially ruled out was very high. The TB diagnostic work-up and linkage to HIV care should be strengthened to decrease TB burden and all-cause mortality among PLHIV with presumptive TB.
结核病（TB）误诊仍然是一个公共卫生关注点，尤其是在艾滋病毒感染者（PLHIV）中，因为漏诊结核病与高死亡率相关。本研究的主要目的是描述在一个最初排除结核病的疑似结核病 PLHIV 队列中，全因死亡率、结核病发病率及其相关危险因素。我们在莫桑比克南部的一个农村地区对疑似结核病的 PLHIV 队列进行了为期 2 年的回顾性随访。在研究期间，共随访了 382 名 PLHIV。死亡率为 6.8/100 人年（95%CI5.2-9.2），结核病发病率为 5.4/100 人年（95%CI3.9-7.5）。36%的死亡和 43%的结核病新发病例发生在随访的前 12 个月。在最初排除结核病后的 2 年期间，死亡率和结核病发病率非常高。应加强结核病诊断工作以及与 HIV 护理的联系，以降低疑似结核病 PLHIV 的结核病负担和全因死亡率。
