{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T02:42:04Z","timestamp":1790563324608,"version":"4.1.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tuberculosis (TB) transmission is heterogenous, yet high-risk populations remain poorly defined. We aimed to assess whether people who smoke drugs (PWSD) have elevated TB disease rates in a high-burden setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited PWSD from a rural community in the Western Cape, South Africa, using respondent-driven sampling (RDS). Participants were \u226515 years old, tested positive for methamphetamine and\/or methaqualone, and completed TB and HIV testing and biobehavioral surveys. We defined TB disease as culturable TB, Xpert MTB\/RIF Ultra (Ultra) MTB detected with no history of TB, Ultra traceamong persons with HIV (PWH) &amp;gt;2 years from any prior diagnosis, or currently on TB treatment. We summarized population-level characteristics and estimated TB prevalence using the RDS-II estimator. We identified characteristics associated with TB using logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between April 2021 and October 2023, we enrolled 750 PWSD. Overall, 71.5% (95% CI, 66.1%\u201376.8%) were male and the mean age was 34 years (95% CI, 33%\u201336%); 17.5% (95% CI, 13.0%\u201322.0%) were PWH, of whom 31.6% were newly diagnosed. RDS-adjusted TB prevalence was 10.4% (95% CI, 6.5%\u201314.3%). TB prevalence among PWSD without HIV was 8.1% (95% CI, 4.4%\u201311.9%), compared to 20.9% (95% CI, 8.4%\u201333.4%) with HIV. PWH had 3.3-fold greater adjusted odds of having TB disease (95% CI, 1.9%\u20135.8%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PWSD identified through RDS had substantially elevated TB and HIV rates, with 20% of PWSD with HIV having TB. We successfully engaged PWSD in TB screening using peer recruitment. These findings highlight opportunities for community transmission identification and interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf481","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T12:07:56Z","timestamp":1759320476000},"page":"763-772","source":"Crossref","is-referenced-by-count":1,"title":["Tuberculosis Disease Prevalence Among People Who Smoke Illicit Drugs: A Respondent- Driven Sampling Study in the Western Cape, South Africa"],"prefix":"10.1093","volume":"233","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0849-2348","authenticated-orcid":false,"given":"Samantha","family":"Malatesta","sequence":"first","affiliation":[{"name":"Department of Biostatistics, School of Public Health, Boston University , Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"Carney","sequence":"additional","affiliation":[{"name":"Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council , Tygerberg"},{"name":"Department of Psychiatry and Mental Health, University of Cape Town"},{"name":"Department of Psychology, University of Johannesburg"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5638-1469","authenticated-orcid":false,"given":"Nandi","family":"Niemand Wolhuter","sequence":"additional","affiliation":[{"name":"South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Overbeck","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University Chobanian and Avedisian School of Medicine , 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Boston University Chobanian and Avedisian School of Medicine , Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1521-148X","authenticated-orcid":false,"given":"Tara C","family":"Bouton","sequence":"additional","affiliation":[{"name":"Section of Infectious Diseases, Department of Medicine, Boston Medical Center and Boston University Chobanian and Avedisian School of Medicine , Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3871-5760","authenticated-orcid":false,"given":"Maha","family":"Farhat","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Harvard Medical School , Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0235-6716","authenticated-orcid":false,"given":"Bronwyn","family":"Myers","sequence":"additional","affiliation":[{"name":"Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council , Tygerberg"},{"name":"Department of Psychiatry and Mental Health, University of Cape Town"},{"name":"Curtin enAble Institute, Faculty of Health Sciences, Curtin University , Perth ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4276-7117","authenticated-orcid":false,"given":"Robin","family":"Wood","sequence":"additional","affiliation":[{"name":"Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town"},{"name":"Aerobiology and TB Research Unit, Desmond Tutu Health Foundation , Cape Town ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Ratangee","sequence":"additional","affiliation":[{"name":"South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of 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