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Published on: September 5, 2017
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Risk factors for and timing of presumptive recurrent TB
A N Shapiro1, L Scott2, H Moultrie3
1Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA;, Health Economics and Epidemiology Research Office, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Summary
Tuberculosis (TB) recurrence is common, with 4.7% of patients experiencing it. Higher TB rates, HIV, and male sex increase recurrence risk, often within a year.
Area of Science:
- Public Health
- Infectious Diseases
- Epidemiology
Background:
- Tuberculosis (TB) recurrence poses a significant challenge to global TB control efforts.
- Understanding the epidemiology of TB recurrence is crucial for targeted interventions.
Purpose of the Study:
- To quantify the burden, risk factors, and timing of presumptive tuberculosis recurrence.
- To identify patient demographics and characteristics associated with higher TB recurrence rates.
Main Methods:
- Retrospective analysis of laboratory test results from South Africa (2013-2017).
- Defined TB episodes based on positive tests and assumed completion times (6 months for RS-TB, 18 months for RR-TB).
- Identified presumptive recurrent TB as a positive test after a prior episode concluded.
Main Results:
- 4.7% of 574,316 individuals with rifampicin-susceptible TB (RS-TB) experienced presumptive recurrence.
- Higher local TB notification rates, HIV coinfection, and male sex were associated with increased recurrence.
- Most (89.4%) first RS-TB recurrences occurred within one year of the initial episode.
Conclusions:
- Recurrent TB is a significant issue, particularly within the first year post-initial episode.
- Identifying high-risk groups (e.g., HIV-positive males in high-incidence areas) can guide early interventions.
- Findings can inform strategies to improve patient care and reduce the overall TB burden.
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