Students believed that research was important and had a positive attitude towards it. However, few had been involved in voluntary research and produced work worthy of presentation and/or publication. Addressing identified barriers and improving students' attitudes may begin to reverse the trend in declining numbers of physician--scientists.
Background We aimed to estimate the prevalence of and explore risk factors for Mycobacterium tuberculosis infection among adolescents in a high tuberculosis (TB) and HIV prevalence setting. Methods A cross-sectional study of adolescents (10–19 years) randomly selected from a demographic surveillance area (DSA) in rural KwaZulu-Natal, South Africa. We determined M. tuberculosis infection status using the QuantiFERON-TB Gold-plus assay. We used HIV data from the DSA to estimate community-level adult HIV prevalence and random effects logistic regression to identify risk factors for TB infection. Results We enrolled 1,094 adolescents (548 [50.1%] female); M. tuberculosis infection prevalence (weighted for non-response by age, sex, and urban/rural residence) was 23.0% (95% confidence interval [CI]: 20.6–25.6%). M. tuberculosis infection was associated with older age (adjusted odds ratio [aOR]: 1.37; 95% CI: 1.10–1.71, for increasing age-group [12–14, 15–17, 18–19 vs. 10–11 years]), ever (vs. never) having a household TB contact (aOR: 2.13, 95% CI: 1.25–3.64) and increasing community-level HIV prevalence (aOR: 1.43, 95% CI: 1.07–1.92, for increasing HIV prevalence category [25–34.9%, 35–44.9%, ≥45% vs. <25%]). Conclusion Our data support prioritising TB prevention and care activities in TB-affected households and high HIV prevalence communities.
Background: HIV-negative men are over-represented in tuberculosis (TB) prevalence surveys including the first South African national TB prevalence survey in 2018. Traditionally, TB screening is focused in clinics. We aimed to determine the frequency of primary healthcare clinic (PHC) attendance among HIV-negative men in a TB-prevalent setting. Methods: Since January 2017, PHC attendees in a rural South African demographic surveillance area (DSA) were asked their reason for attendance. HIV status was defined as positive if tested positive in a DSA sero-survey or attended clinic for HIV care; negative if tested negative between January 2014—December 2017 and no HIV-related visits; and HIV-unknown otherwise. Results: Among 67124 DSA residents (≥15 years), 27038 (40.3%) were men; 14196 (21.2%) were classified HIV-positive, 18892 (28.1%) HIV-negative and 34036 (50.7%) HIV-unknown. Between April 2017 and March 2018, 24382/67124 (36.3%, 95% confidence interval [CI] 36.0–36.7) adults made ≥1 PHC visit, comprising 9805/40086 (24.5%, 95%CI 23.6–25.3) of HIV-negative or unknown women and 3440/27038 (12.7%, 95%CI 11.6–13.8) of HIV-negative or unknown men. Overall, HIV care accounted for 37556/88109 (42.6%) of adult PHC visits. Conclusion: In this rural population, HIV-negative and -unknown men rarely attend PHCs. Improving TB screening in clinics may not reach a key population with respect to undiagnosed TB. Additional strategies are needed to diagnose and treat TB earlier.
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