{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T08:02:41Z","timestamp":1778572961981,"version":"3.51.4"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T00:00:00Z","timestamp":1647561600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1116635"],"award-info":[{"award-number":["OPP1116635"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>Despite high exposure to<jats:italic>Mycobacterium tuberculosis<\/jats:italic>, a small proportion of South African goldminers resist TB infection. We determined, among long-service gold miners i) the proportion who were TB uninfected and ii) epidemiological factors associated with being uninfected.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>We enrolled HIV-negative gold miners aged 33\u201360 years with \u226515 years\u2019 service and no history of TB or silicosis. Miners were defined as TB uninfected if i) QuantiFERON-TB Gold Plus (QFT-Plus) negative or ii) in a stricter definition, QFT-Plus-negative and zero-response on TST and as resisters if they were of Black\/African ethnicity and negative on both tests. Logistic regression was used to identify epidemiological factors associated with being TB uninfected.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>Of 307 participants with a QFT-Plus result, median age was 48 years (interquartile range [IQR] 44\u201353), median time working underground was 24 years (IQR 18\u201328), 303 (99%) were male and 91 (30%) were QFT-Plus-negative. The odds of being TB uninfected was 52% lower for unskilled workers (adjusted odds ratio [aOR] 0.48; 95% confidence interval [CI] 0.27\u20130.85; p = 0.013). Among 281 participants of Black\/African ethnicity, 71 (25%) were QFT-Plus negative. Miners with a BMI \u226530 were less likely to be TB uninfected (OR 0.38; 95% CI 0.18\u20130.80). Using the stricter definition, 44.3% (136\/307) of all miners were classified as either TB uninfected (35; 26%) or infected, (101; 74%) and the associations remained similar. Among Black\/African miners; 123 were classified as either TB uninfected (23; 19%) or infected (100; 81%) using the stricter definition. No epidemiological factors for being TB uninfected were identified.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>Despite high cumulative exposure, a small proportion of miners appear to be resistant to TB infection and are without distinguishing epidemiological characteristics.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0265036","type":"journal-article","created":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T17:30:39Z","timestamp":1647624639000},"page":"e0265036","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":17,"title":["Resistance to Mycobacterium tuberculosis infection among highly TB exposed South African gold miners"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1444-9266","authenticated-orcid":true,"given":"Violet 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