Journal Article DKFZ-2026-00752

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High two-month mortality in Gabonese adults with and without tuberculosis: A prospective cohort study of patients with presumed pulmonary tuberculosis.

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2026
Elsevier [Amsterdam]

IJID regions 19, 100870 () [10.1016/j.ijregi.2026.100870]
 GO

Abstract: Pulmonary tuberculosis (PTB) remains a leading cause of mortality in sub-Saharan Africa but often remains unconfirmed. Patient outcomes in unconfirmed TB or non-TB cases are rarely studied. We assessed 2-month outcomes and associated factors in presumed TB cases independent of TB status.Hospitalized adults with presumed PTB in Lambaréné, Gabon, were prospectively enrolled (September 2024-January 2025). Demographic data, including a socioeconomic status (SES) score, were collected. Laboratory analyses included HIV-test, GeneXpert and mycobacterial culture. Chest X-rays (CXR) were assessed for signs of TB and non-TB conditions. Diagnoses were categorized as confirmed PTB, clinically diagnosed PTB, or non-TB. Two-month follow-up assessed outcomes.Of 103 participants, 30 of 102 (29%) were HIV positive. Median age was 44 years (interquartile range 28-57). PTB was confirmed in 34 of 103 (33%), clinically diagnosed in 5 of 103 (5%), and not diagnosed in 62 of 103 (62%). In the non-TB group, CXR findings were consistent with bacterial pneumonia (24/62, 39%) or malignancy (12/62, 19%). At follow-up, 81 of 100 (81%) reported improvement, whereas 19 of 100 (19%) did not, including 12 of 100 (12%) deaths. HIV infection, smoking, alcohol use, rural residence, and lower SES were associated with death, no difference was seen by TB status.High 2-month mortality, regardless of final TB status, highlights the need for improved access to diagnostics and better treatment algorithms in severe respiratory illness.German Clinical Trials Register (DRKS00034074).

Keyword(s): Diagnosis ; HIV ; Mortality ; Respiratory infections ; Sub-Saharan Africa ; Tuberculosis

Classification:

Contributing Institute(s):
  1. Infektionen und Krebsepidemiologie (C230)
Research Program(s):
  1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2026
Database coverage:
Medline ; DOAJ ; Article Processing Charges ; Clarivate Analytics Master Journal List ; DOAJ Seal ; Emerging Sources Citation Index ; Fees ; SCOPUS ; Web of Science Core Collection
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 Record created 2026-03-31, last modified 2026-03-31


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