Tuberculosis on the rise in southern Mozambique (1997–2012)

García‐Basteiro, Alberto L.; Ribeiro, Rafaela; Brew, Joe; Sacoor, Charfudin; Valencia, Salomé; Bulo, Helder; Cobelens, Frank; Macete, Eusébio

doi:10.1183/13993003.01683-2016

Cited by 17 publications

(10 citation statements)

References 11 publications

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“…TB incidence rates found in our study are very high (5.41/100 PYs), higher than the TB incidence rates in the general HIV-positive population in our setting 4 . Our TB incidence is almost 10 times higher than the TB incidence rate found in a recent retrospective cohort analysis in Nigeria among HIV-positive patients initiating cART (0.57/100PYs) 38 and in a study in rural Tanzania (1.7/100PYs) 39 .…”

Section: Discussioncontrasting

confidence: 82%

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Mortality and risk of tuberculosis among people living with HIV in whom TB was initially ruled out

García

Mambuque

Nguenha

et al. 2020

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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.

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Section: Discussioncontrasting

confidence: 82%

“…Mozambique is one of the 14 countries included in the high TB, TB/HIV and MDR-TB burden lists, with an estimated TB incidence rate of 551 (356–787) cases per 100,000 in 2018 1 . As it has been estimated that around half of TB cases are not diagnosed (or reported to the health authorities) case detection rates are presumably low 4 , 5 .…”

Section: Introductionmentioning

confidence: 99%

Mortality and risk of tuberculosis among people living with HIV in whom TB was initially ruled out

García

Mambuque

Nguenha

et al. 2020

Sci Rep

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“…Further studies are required to replicate and corroborate our laboratory results in field settings with scarce diagnostic techniques and delayed diagnosis 29 using urine from human subjects with presumable symptoms of active TB, as well as using milk from cattle presumable with symptoms of bovine TB.…”

Section: Discussionmentioning

confidence: 91%

Improved Alere Determine Lipoarabinomannan Antigen Detection Test for the Diagnosis of Human and Bovine Tuberculosis by Manipulating Urine and Milk

García

Kelley

Meléndez

et al. 2019

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Tuberculosis (TB) disease still kills 1-person every 21-seconds. Few TB diagnostic tests are considered truly appropriate for point of care settings. The WHO-endorsed immunodiagnostic Alere Determine Lipoarabinomannan Ag-test (LAM-test) detects Mycobacterium tuberculosis complex LAM in urine, and its use is recommended for TB diagnosis among HIV co-infected individuals with low CD4 T-cell counts. Here we found that a simple 15-minute enzymatic treatment at room temperature of LAM-spiked urine with α-mannosidase (for human TB), and LAM-spiked milk with combined lactase and caseinase (for bovine TB), enhanced 10-fold the detection levels of the LAM-test and thus, improved the detection of LAM by the LAM-test in urine and milk that otherwise could be missed in the field. Future separate clinical research studies specifically designed to address the potential of these findings are required.

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“…Mozambique, a malaria endemic country, has also been hard hit by the HIV and tuberculosis dual epidemic, 12 which compromises the country’s social and economic progress. Since the 1990s, the HIV has shown an extremely rapid progression, affecting, in some settings, up to 45% in women aged 28–47 as reported in a recent community-based study in a rural district of Maputo province.…”

Section: The Example Of Mozambiquementioning

confidence: 99%

Weak surveillance and policy attention to cancer in global health: the example of Mozambique

et al. 2018

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Cancer is an emerging public health problem in sub-Saharan Africa due to population growth, ageing and westernisation of lifestyles. The increasing burden of cancer calls for urgent policy attention to develop cancer prevention and control programmes. Cancer surveillance is an essential prerequisite. Only one in five low-income and middle-income countries have the necessary data to drive policy and reduce the cancer burden. In this piece, we use data from Mozambique over a 50-year period to illustrate cancer epidemiological trends in low-income and middle-income countries to hypothesise potential circumstances and factors that could explain changes in cancer burden and to discuss surveillance weaknesses and potential improvements. Like many low-income and middle-income countries, Mozambique faces the dual challenge of a still high morbidity and mortality due to infectious diseases in rural areas and increased incidence of cancers associated with westernisation of lifestyles in urban areas, as well as a rise of cancers related to the HIV epidemic. An increase in cancer burden and changes in the cancer profile should be expected in coming years. The Mozambican healthcare and health-information systems, like in many other low-income and middle-income countries, are not prepared to face this epidemiological transition, which deserves increasing policy attention.

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Tuberculosis on the rise in southern Mozambique (1997–2012)

Cited by 17 publications

References 11 publications

Mortality and risk of tuberculosis among people living with HIV in whom TB was initially ruled out

Mortality and risk of tuberculosis among people living with HIV in whom TB was initially ruled out

Improved Alere Determine Lipoarabinomannan Antigen Detection Test for the Diagnosis of Human and Bovine Tuberculosis by Manipulating Urine and Milk

Weak surveillance and policy attention to cancer in global health: the example of Mozambique

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