{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T23:01:59Z","timestamp":1778367719236,"version":"3.51.4"},"reference-count":67,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,8,7]],"date-time":"2019-08-07T00:00:00Z","timestamp":1565136000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>This paper assesses patient\u2010 and population\u2010level trends in TB notifications during rapid expansion of antiretroviral therapy in Eswatini which has an extremely high incidence of both TB and HIV.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patient\u2010 and population\u2010level predictors and rates of HIV\u2010associated TB were examined in the Shiselweni region in Eswatini from 2009 to 2016. Annual population\u2010level denominators obtained from projected census data and prevalence estimates obtained from population\u2010based surveys were combined with individual\u2010level TB treatment data. Patient\u2010 and population\u2010level predictors of HIV\u2010associated TB were assessed with multivariate logistic and multivariate negative binomial regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 11\u00a0328 TB cases, 71.4% were HIV co\u2010infected and 51.8% were women. TB notifications decreased fivefold between 2009 and 2016, from 1341 to 269 cases per 100\u00a0000 person\u2010years. The decline was sixfold in PLHIV vs. threefold in the HIV\u2010negative population. Main patient\u2010level predictors of HIV\u2010associated TB were recurrent TB treatment (adjusted odds ratio [aOR] 1.40, 95% confidence interval [CI]: 1.19\u20131.65), negative (aOR 1.31, 1.15\u20131.49) and missing (aOR 1.30, 1.11\u20131.53) bacteriological status and diagnosis at secondary healthcare level (aOR 1.18, 1.06\u20131.33). Compared with 2009, the probability of TB decreased for all years from 2011 (aOR 0.69, 0.58\u20130.83) to 2016 (aOR 0.54, 0.43\u20130.69). The most pronounced population\u2010level predictor of TB was HIV\u2010positive status (adjusted incidence risk ratio 19.47, 14.89\u201325.46).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This high HIV\u2010TB prevalence setting experienced a rapid decline in TB notifications, most pronounced in PLHIV. Achievements in HIV\u2010TB programming were likely contributing factors.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13290","type":"journal-article","created":{"date-parts":[[2019,7,16]],"date-time":"2019-07-16T09:57:57Z","timestamp":1563271077000},"page":"1114-1127","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Decreased risk of HIV\u2010associated TB during antiretroviral therapy expansion in rural Eswatini from 2009 to 2016: a cohort and population\u2010based analysis"],"prefix":"10.1111","volume":"24","author":[{"given":"Bernhard","family":"Kerschberger","sequence":"first","affiliation":[{"name":"M\u00e9decins Sans Fronti\u00e8res (Operational Centre Geneva) Mbabane Eswatini"},{"name":"Centre for Infectious Disease Epidemiology and Research, School of Public Health and Family Medicine University of Cape Town Cape Town South 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