{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T20:48:15Z","timestamp":1775854095898,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2016,7,25]],"date-time":"2016-07-25T00:00:00Z","timestamp":1469404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Odense University Free Research Funds"},{"name":"Danish Funds"},{"name":"AIDS Fund"},{"name":"Augustinus Fund"},{"name":"Torben og Alice Frimodts Fund"},{"name":"Aase og Ejnar Danielsens Fund"},{"name":"AP M\u00f8ller Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the prevalence and clinical importance of previously unrecognised tuberculosis (<jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>) and isolation of non\u2010tuberculous mycobacteria (<jats:styled-content style=\"fixed-case\">NTM<\/jats:styled-content>) among <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected individuals in a teaching hospital in Ghana.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Intensified mycobacterial case finding was conducted among <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010positive individuals before initiation of antiretroviral therapy (<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>). Data were collected on socio\u2010demographic characteristics, medical history and <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>\u2010related signs and symptoms, and participants were followed for six months to determine treatment and vital status. Two sputum samples were obtained and examined for mycobacteria with smear microscopy, culture and Xpert <jats:styled-content style=\"fixed-case\">MTB<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">RIF<\/jats:styled-content> assay. <jats:styled-content style=\"fixed-case\">NTM<\/jats:styled-content> species were identified with the GenoType Mycobacterium <jats:styled-content style=\"fixed-case\">CM<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">AS<\/jats:styled-content> or sequence analysis of 16S <jats:styled-content style=\"fixed-case\">rRNA<\/jats:styled-content> gene.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 473 participants, 60 (12.7%) had confirmed pulmonary <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content>, and 38 (8.0%) had positive cultures for <jats:styled-content style=\"fixed-case\">NTM<\/jats:styled-content>. <jats:italic>Mycobacterium avium<\/jats:italic> complex was identified in 9\/38 (23.7%) of <jats:styled-content style=\"fixed-case\">NTM<\/jats:styled-content> isolates. Participants with <jats:styled-content style=\"fixed-case\">NTM<\/jats:styled-content> isolated were more likely to have <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 cell count&lt; 100 cells\/<jats:italic>\u03bc<\/jats:italic>L (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 2.37; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.10\u20105.14), <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>&lt;18.5kg\/m<jats:sup>2<\/jats:sup> (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 2.51; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.15\u20105.51) and fever \u22652 weeks (<jats:styled-content style=\"fixed-case\">aOR<\/jats:styled-content> 2.76; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.27\u20106.03) at baseline than participants with no mycobacteria. By six months, 76 (16.1%) participants had died; 20 (33.3%) with confirmed <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> and 9 (23.7%) with <jats:styled-content style=\"fixed-case\">NTM<\/jats:styled-content>\u2010positive culture. Mortality at six months was independently associated with <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> diagnosis at enrolment (<jats:styled-content style=\"fixed-case\">aHR<\/jats:styled-content> 1.97; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.09\u20103.59), but not with <jats:styled-content style=\"fixed-case\">NTM<\/jats:styled-content> isolation after controlling for age, sex, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>4 cell count, <jats:styled-content style=\"fixed-case\">BMI<\/jats:styled-content>, prolonged fever and <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> initiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intensified mycobacterial screening of <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content>\u2010infected individuals revealed a high burden of unrecognised pulmonary <jats:styled-content style=\"fixed-case\">TB<\/jats:styled-content> before <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> initiation, which increased risk of death within six months. <jats:styled-content style=\"fixed-case\">NTM<\/jats:styled-content> were frequently isolated and associated with signs of poor clinical status but not with increased mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.12749","type":"journal-article","created":{"date-parts":[[2016,7,6]],"date-time":"2016-07-06T16:25:41Z","timestamp":1467822341000},"page":"1181-1190","source":"Crossref","is-referenced-by-count":28,"title":["Tuberculosis and non\u2010tuberculous mycobacteria among <scp>HIV<\/scp>\u2010infected individuals in Ghana"],"prefix":"10.1111","volume":"21","author":[{"given":"Stephanie","family":"Bjerrum","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Odense University Hospital Odense Denmark"},{"name":"Institute of Clinical Research University of Southern Denmark Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Oliver\u2010Commey","sequence":"additional","affiliation":[{"name":"Fevers Unit Department of Medicine Korle\u2010Bu Teaching Hospital Accra Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernest","family":"Kenu","sequence":"additional","affiliation":[{"name":"Fevers Unit Department of Medicine Korle\u2010Bu Teaching Hospital Accra Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Lartey","sequence":"additional","affiliation":[{"name":"Fevers Unit Department of Medicine Korle\u2010Bu Teaching Hospital Accra Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mercy Jemima","family":"Newman","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology University of Ghana Accra Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kennedy Kwasi","family":"Addo","sequence":"additional","affiliation":[{"name":"Department of Bacteriology University of Ghana Accra Ghana"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doris","family":"Hilleman","sequence":"additional","affiliation":[{"name":"National Reference Centre for Mycobacteria Research Centre Borstel S\u00fclfeld Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aase Bengaard","family":"Andersen","sequence":"additional","affiliation":[{"name":"Institute of Clinical Research University of Southern Denmark Odense Denmark"},{"name":"Department of Infectious Diseases Copenhagen University Hospital Rigshospitalet Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isik Somuncu","family":"Johansen","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases Odense University Hospital Odense Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,7,25]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0028691"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000000802"},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1097\/QAD.0b013e3283390dd1","article-title":"Tuberculosis during the first year of antiretroviral therapy in a South African cohort using an intensive pretreatment screening strategy","volume":"24","author":"Lawn SD","year":"2010","journal-title":"AIDS"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/656282"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0085478"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200604-571ST"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1333567"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(04)01130-2"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/146.2.285"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0000615"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201107-1327OC"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1264-6"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1501.081093"},{"key":"e_1_2_7_15_1","volume-title":"Tuberculosis Country Profile, Ghana","author":"World Health Organization","year":"2014"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/trstmh\/tru110"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-015-1151-1"},{"key":"e_1_2_7_18_1","volume-title":"Antiretroviral Therapy for HIV Infection in Adults and Adolescents: Recommendations for a Public Health Approach \u2010 2010 Revision","author":"World Health Organization","year":"2010"},{"key":"e_1_2_7_19_1","unstructured":"Ghana Health Service.National HIV\/AIDS\/STI Control Programme Guidelines for antiretroviral therapy in Ghana 2010. (Available from:http:\/\/www.ghanaids.gov.gh\/gac1\/pubs\/Guidelines_for_Antiretroviral_Therapy_in_Ghana_2010_NACP.pdf[22 Apr 2015]"},{"key":"e_1_2_7_20_1","unstructured":"STOP TB Partnership.GLiaTd. Mycobacteriology Laboratory Manual 2014."},{"key":"e_1_2_7_21_1","volume-title":"Tuberculosis Microscopy Laboratory Manual for Ghana","author":"Ghana Health Service","year":"2012"},{"key":"e_1_2_7_22_1","volume-title":"Tuberculosis Culture\/Drug Susceptibility Testing Laboratory Manual for Ghana","author":"Ghana Health Service","year":"2012"},{"key":"e_1_2_7_23_1","volume-title":"Guidelines for the Clinical Management of TB and HIV Co\u2010Infection in Ghana","author":"Ghana Health Services","year":"2007"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0111400"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.13.0117"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001067"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31823d3aba"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32830007cd"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e3182303716"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000238406.93249.cd"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir411"},{"key":"e_1_2_7_32_1","unstructured":"Panel on Opportunistic Infections in HIV\u2010Infected Adults and Adolescents.Guidelines for the prevention and treatment of opportunistic infections in HIV\u2010infected adults and adolescents: recommendations from the Centers for Disease Control and Prevention the National Institutes of Health and the HIV Medicine Association of the Infectious Diseases Society of America.Available athttp:\/\/aidsinfo.nih.gov\/contentfiles\/lvguidelines\/adult_oi.pdf. Accessed [30 Sep 2015]."},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00149212"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2009.03072.x"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0063170"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200409240-00015"},{"issue":"1","key":"e_1_2_7_37_1","first-page":"CD009593","article-title":"Xpert(R) MTB\/RIF assay for pulmonary tuberculosis and rifampicin resistance in adults","author":"Steingart KR","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006927"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-003499"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0005790"}],"container-title":["Tropical Medicine &amp; International Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftmi.12749","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.12749","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tmi.12749","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tmi.12749","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T13:53:24Z","timestamp":1696168404000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tmi.12749"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,25]]},"references-count":39,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2016,9]]}},"alternative-id":["10.1111\/tmi.12749"],"URL":"https:\/\/doi.org\/10.1111\/tmi.12749","archive":["Portico"],"relation":{},"ISSN":["1360-2276","1365-3156"],"issn-type":[{"value":"1360-2276","type":"print"},{"value":"1365-3156","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,25]]}}}