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Incidence of pulmonary tuberculosis in suburban Bissau, Guinea-Bissau between 2004 and 2020: a prospective cohort study

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Abstract

Objectives

Previous studies have found declining incidence of tuberculosis (TB) in Bissau, Guinea-Bissau. This study aimed to report incidence rates of TB for the period 2004–2020, stratifying by sex, smear-status, and HIV-status, as well as describe developments in TB case fatality rate and diagnostic delay.

Design and methods

Data from the Bandim Health Project HDSS and the TB registry from Jan 1st, 2004 to Dec 31st, 2020 were used. Incidence rates were calculated for each year and for smear-positive, smear-negative, HIV-positive, HIV-negative, and unknown HIV-status. Incidence rate ratio and test for trend were done using a one-step Newton approximation to the log-linear Poisson regression coefficient.

Results

Overall TB incidence declined only slightly over the period from 294 per 100,000 in 2004 to 273 in 2020. TB/HIV coinfection declined from 108 in 2004 to 14 in 2020, as did incidence among females and smear-negative cases.

Conclusions

Incidence of PTB in Bissau, Guinea-Bissau is declining slowly, if at all. TB incidence among females, smear-negative TB, TB case fatality rate, and TB/HIV coinfection and diagnostic delay are declining.

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Data availability

The data underlying this article will be shared on reasonable request to the corresponding author.

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Acknowledgements

We owe a debt of gratitude to our patients in Bissau for participating in the study as well as to the assistants, nurses, and physicians involved in the study for their dedication and consistent work.

Funding

This work was supported by grants from the Dagmar Marshall Foundation (500020), Else and Mogens Wedell Wedellsborg Foundation (12-20-1), Aarhus University Research Foundation (26101), Reinholdt W. Jorck and Wife Foundation (19-JU-0367), Augustinus Foundation (19-3361), and A.P. Møller Foundation (19-L-0064).

Author information

Authors and Affiliations

  1. Bandim Health Project, INDEPTH Network, Apartado 861, Bissau, Guinea-Bissau

    Anders Solitander Bohlbro, Antonio Matteus Mendes, Armando Sifna, Victor Gomes, Frauke Rudolf & Christian Wejse

  2. Department of Infectious Diseases, Aarhus University Hospital, Palle Juul-Jensens, Boulevard 99, 8200, Aarhus N, Denmark

    Anders Solitander Bohlbro, Frauke Rudolf & Christian Wejse

  3. GloHAU, Center for Global Health, Department of Public Health, Aarhus University, Aarhus, Denmark

    Anders Solitander Bohlbro & Christian Wejse

Authors
  1. Anders Solitander Bohlbro
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  2. Antonio Matteus Mendes
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  3. Armando Sifna
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  4. Victor Gomes
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  5. Frauke Rudolf
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  6. Christian Wejse
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Contributions

ASB analyzed data and prepared the manuscript; AMM performed a supervisory and field assistant role; AS acted as experienced TB physician; Victor Gomes was advisor of the National TB Program in Guinea-Bissau; FR performed a supervisory role; and CW was primary supervisor. All authors reviewed the manuscript prior to submission.

Corresponding author

Correspondence to Anders Solitander Bohlbro.

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Conflict of interest

The authors declare no competing interests.

Ethical approval statement

The TB surveillance programme was approved by the Guinean Ministry of Health and the Danish National Committee on Health Research Ethics. Patients provided written informed consent; for adolescents aged 15-17 assent from parents/legal guardian was required. All participants were offered HIV-testing with pre- and post-test counseling.

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Bohlbro, A.S., Mendes, A.M., Sifna, A. et al. Incidence of pulmonary tuberculosis in suburban Bissau, Guinea-Bissau between 2004 and 2020: a prospective cohort study. Infection 51, 955–966 (2023). https://doi.org/10.1007/s15010-022-01958-w

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  • DOI: https://doi.org/10.1007/s15010-022-01958-w

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