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Incidence and Determinants of Tuberculosis among Adults Initiating Antiretroviral Therapy – Mozambique, 2004–2008

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  • Andrew F Auld
  • Francisco Mbofana
  • Ray W Shiraishi
  • Charity Alfredo
  • Mauro Sanchez
  • Tedd V Ellerbrock
  • Lisa J Nelson

Abstract

Background: In Mozambique, tuberculosis (TB) is thought to be the most common cause of death among antiretroviral therapy (ART) enrollees. Monitoring proportions of enrollees screened for TB, and incidence and determinants of TB during ART can help clinicians and program managers identify program improvement opportunities. Methodology/Principal Findings: We conducted a retrospective cohort study among a nationally representative sample of the 79,500 adults (>14 years old) initiating ART during 2004–2007 to estimate clinician compliance with TB screening guidelines, factors associated with active TB at ART initiation, and incidence and predictors of documented TB during ART follow-up. Of 94 sites enrolling >50 adults on ART, 30 were selected using probability-proportional-to-size sampling; 2,596 medical records at these sites were randomly selected for abstraction and analysis. At ART initiation, median age of patients was 34, 62% were female, median baseline CD4+ T-cell count was 153/µL, and 11% were taking TB treatment. Proportions of records with TB screening documentation before ART initiation improved from 31% to 66% during 2004–2007 (p

Suggested Citation

  • Andrew F Auld & Francisco Mbofana & Ray W Shiraishi & Charity Alfredo & Mauro Sanchez & Tedd V Ellerbrock & Lisa J Nelson, 2013. "Incidence and Determinants of Tuberculosis among Adults Initiating Antiretroviral Therapy – Mozambique, 2004–2008," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-11, January.
    • Handle: RePEc:plo:pone00:0054665
    DOI: 10.1371/journal.pone.0054665
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