{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T20:56:28Z","timestamp":1781643388680,"version":"3.54.5"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Epidemiol Glob Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Communicable diseases remain one of the major public health challenges in Sub-Saharan Africa, with tuberculosis (TB) ranking among the leading causes of morbidity, mortality, and significant economic impact. Mozambique is among the countries with the highest TB burden in the region. This study aimed to develop a clinical prediction model, in the form of a nomogram, to predict the probability of unfavorable treatment outcomes (UTO) among TB patients treated at a district health center in Nacar\u00f4a, Nampula Province, Mozambique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted using secondary data from patients diagnosed and treated for TB between 2021 and 2023. A multivariable logistic regression analysis was performed to identify factors associated with UTO, and a predictive nomogram was subsequently constructed. Model performance was assessed using the receiver operating characteristic (ROC) curve, accuracy, Brier Score (BS), calibration plot, and the Hosmer\u2013Lemeshow goodness-of-fit test. Clinical utility was evaluated through decision curve analysis (DCA) and clinical impact curves.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      UTO were observed in 26.8% of patients (55\/205). The multivariable analysis identified as significant predictors of UTO being previously treated for TB, not receiving directly observed therapy (DOT), having a clinical or radiological diagnosis, and having a positive smear microscopy result. The nomogram showed good performance, with an AUC of 83.2% and an accuracy of 84.9%. The Hosmer\u2013Lemeshow test indicated good model fit (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.132), and the calibration plot demonstrated strong agreement between predicted and observed outcomes (BS\u2009=\u20090.119). DCA and clinical impact analyses confirmed the model\u2019s potential to support and optimize clinical decision-making in TB management.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The nomogram developed in this study represents a promising and practical tool for estimating the individual risk of UTO in tuberculosis care and may contribute to improved clinical management and resource allocation in high-burden settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s44197-026-00532-z","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T11:39:25Z","timestamp":1773833965000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Novel Clinical Nomogram for Predicting Unfavorable Tuberculosis Treatment Outcomes: A Logistic Regression Risk Model"],"prefix":"10.1007","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9493-4098","authenticated-orcid":false,"given":"Sancho Pedro","family":"Xavier","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gelc\u00eddio Alfredo Pereira","family":"Rafael","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Raquel Manuel Ernesto","family":"Gotine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateus Ant\u00f3nio","family":"Agostinho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graciano","family":"Cumaquela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zito Ant\u00f3nio Joaquim","family":"Rocha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aud\u00eancio","family":"Victor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,18]]},"reference":[{"key":"532_CR1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14072154","author":"R Cioboata","year":"2025","unstructured":"Cioboata R, Balteanu MA, Osman A, Vlasceanu SG, Zlatian OM, Mitroi DM, et al. 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As the dataset only contained existing records and there was no direct contact with participants, obtaining individual informed consent was not possible. These authorities therefore waived the requirement for informed consent. All procedures complied with recognised ethical standards for research and the principles of the 2013 Declaration of Helsinki.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval and Consent to Participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"35"}}