IJID regions · 2026
High two-month mortality in Gabonese adults with and without tuberculosis: A prospective cohort study of patients with presumed pulmonary tuberculosis.
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Weber Stefan Fabian, Glaser Anne, Adegbite Bayodé Roméo, Agbo Achimi Abdul Jabar Babatunde Pacome, Ibinda Guy Arnault Rogue Mfoumbi, Ndanga Micheska Epola Dibamba, Gouleu Christiane Sidonie, Nzambe Jean-Ulrich Muandze, Tobian Frank, Muchie Kindie Fentahun, Gaeddert Mary, Mbaïdiguim Fabrice, Chetcuti Karen, Lanzer Michael, Denkinger Claudia M, Grobusch Martin Peter, Adegnika Ayola Akim, Bélard Sabine, NoTB study group
Аннотация
OBJECTIVES: Pulmonary tuberculosis (PTB) remains a leading cause of mortality in sub-Saharan Africa but often remains unconfirmed. Patient outcomes in unconfirmed TB or non-TB cases are rarely studied. We assessed 2-month outcomes and associated factors in presumed TB cases independent of TB status.
METHODS: Hospitalized adults with presumed PTB in Lambaréné, Gabon, were prospectively enrolled (September 2024-January 2025). Demographic data, including a socioeconomic status (SES) score, were collected. Laboratory analyses included HIV-test, GeneXpert and mycobacterial culture. Chest X-rays (CXR) were assessed for signs of TB and non-TB conditions. Diagnoses were categorized as confirmed PTB, clinically diagnosed PTB, or non-TB. Two-month follow-up assessed outcomes.
RESULTS: Of 103 participants, 30 of 102 (29%) were HIV positive. Median age was 44 years (interquartile range 28-57). PTB was confirmed in 34 of 103 (33%), clinically diagnosed in 5 of 103 (5%), and not diagnosed in 62 of 103 (62%). In the non-TB group, CXR findings were consistent with bacterial pneumonia (24/62, 39%) or malignancy (12/62, 19%). At follow-up, 81 of 100 (81%) reported improvement, whereas 19 of 100 (19%) did not, including 12 of 100 (12%) deaths. HIV infection, smoking, alcohol use, rural residence, and lower SES were associated with death, no difference was seen by TB status.
CONCLUSION: High 2-month mortality, regardless of final TB status, highlights the need for improved access to diagnostics and better treatment algorithms in severe respiratory illness.
STUDY REGISTRY: German Clinical Trials Register (DRKS00034074).
METHODS: Hospitalized adults with presumed PTB in Lambaréné, Gabon, were prospectively enrolled (September 2024-January 2025). Demographic data, including a socioeconomic status (SES) score, were collected. Laboratory analyses included HIV-test, GeneXpert and mycobacterial culture. Chest X-rays (CXR) were assessed for signs of TB and non-TB conditions. Diagnoses were categorized as confirmed PTB, clinically diagnosed PTB, or non-TB. Two-month follow-up assessed outcomes.
RESULTS: Of 103 participants, 30 of 102 (29%) were HIV positive. Median age was 44 years (interquartile range 28-57). PTB was confirmed in 34 of 103 (33%), clinically diagnosed in 5 of 103 (5%), and not diagnosed in 62 of 103 (62%). In the non-TB group, CXR findings were consistent with bacterial pneumonia (24/62, 39%) or malignancy (12/62, 19%). At follow-up, 81 of 100 (81%) reported improvement, whereas 19 of 100 (19%) did not, including 12 of 100 (12%) deaths. HIV infection, smoking, alcohol use, rural residence, and lower SES were associated with death, no difference was seen by TB status.
CONCLUSION: High 2-month mortality, regardless of final TB status, highlights the need for improved access to diagnostics and better treatment algorithms in severe respiratory illness.
STUDY REGISTRY: German Clinical Trials Register (DRKS00034074).