Volume 32, Number 3—March 2026
Dispatch
Tuberculosis after TB Preventive Therapy in Persons Living with HIV Recently Initiating Antiretroviral Therapy, Mozambique
Lindsay Templin
, Yagna Varajidas, Durval Respeito, Pereira Zindoga, Debora Weiss, Alexandre Nguimfack, Eudoxia Filipe, Arlete Mahumane, Maria Inês Tomo de Deus, José Mizela, Sonia Chilundo, Bruno Simoes, Aleny Couto, Ishani Pathmanathan, Emilio Dirlikov, and Benedita José
, Yagna Varajidas, Durval Respeito, Pereira Zindoga, Debora Weiss, Alexandre Nguimfack, Eudoxia Filipe, Arlete Mahumane, Maria Inês Tomo de Deus, José Mizela, Sonia Chilundo, Bruno Simoes, Aleny Couto, Ishani Pathmanathan, Emilio Dirlikov, and Benedita José
Table 2
Incidence of TB among persons living with HIV newly initiated on ART after 2 years of follow-up, Mozambique, 2021–2024*
| Characteristic | No. TB positive | Person-years | Incidence (95% CI) | Univariate analysis |
Multivariate analysis |
|||
|---|---|---|---|---|---|---|---|---|
| IRR (95% CI) | p value | IRR (95% CI) | p value | |||||
| TPT completion status | ||||||||
| Complete | 1,550 | 492,835 | 3.1 (3.0–3.3) | Referent | Referent | |||
| Incomplete | 1,346 | 122,675 | 11.0 (10.4–11.6) | 3.5 (3.2–3.8) | <0.001 | 3.83 (3.5–4.2) | <0.001 | |
| Not started |
231 |
10,705 |
21.6 (18.9–24.5) |
6.9 (5.7–8.3) |
<0.001 |
5.25 (4.4–6.3) |
<0.001 |
|
| Sex | ||||||||
| F | 1,553 | 393,961 | 3.9 (3.7–4.1) | Referent | Referent | |||
| M |
1,574 |
232,254 |
6.8 (6.4–7.1) |
1.7 (1.6–1.9) |
<0.001 |
1.56 (1.4–1.7) |
<0.001 |
|
| Viral load result† | ||||||||
| Suppressed | 2,603 | 579,825 | 4.5 (4.3–4.7) | Referent | Referent | |||
| Unsuppressed |
524 |
46,390 |
11.3 (10.3–12.3) |
2.5 (2.3–2.8) |
<0.001 |
2.28 (2.0–2.5) |
<0.001 |
|
| Age group | ||||||||
| 15–49 | 2,352 | 541,281 | 4.3 (4.2–4.5) | Referent | Referent | |||
| >50 | 477 | 52,035 | 9.2 (8.4–10.0) | 2.1 (1.9–2.4) | <0.001 | 1.55 (1.4–1.8) | <0.001 | |
| <15 |
298 |
32,899 |
9.1 (8.1–10.1) |
2.1 (1.8–2.4) |
<0.001 |
1.76 (1.6–2.0) |
<0.001 |
|
| TPT regimen‡ | ||||||||
| Isoniazid | 2,672 | 583,015 | 4.6 (4.4–4.8) | Referent | ||||
| 3HP | 224 | 32,495 | 6.9 (6.0–7.9) | 1.5 (1.2–1.8) | <0.001 | |||
| No TPT |
231 |
10,705 |
21.6 (18.9–24.5) |
4.7 (3.9–5.6) |
<0.001 |
|||
| Health facility setting | ||||||||
| Rural | 1,749 | 392,126 | 4.5 (4.3–4.7) | Referent | Referent | |||
| Urban |
1,378 |
234,089 |
5.9 (5.6–6.2) |
1.3 (1.1–1.5) |
<0.001 |
1.21 (1.1–1.4) |
<0.001 |
|
| Region§ | ||||||||
| Northern | 796 | 185,636 | 4.3 (4.0–4.6) | Referent | Referent | |||
| Central | 1,295 | 289,951 | 4.5 (4.2–4.7) | 1.0 (0.9–1.3) | 0.67 | 0.84 (0.7–1.0) | 0.02 | |
| Southern |
1,036 |
150,628 |
6.9 (6.5–7.3) |
1.6 (1.4–1.9) |
<0.001 |
1.51 (1.3–1.8) |
<0.001 |
|
| Latest CD4 result | ||||||||
| >200 cells/mm3 | 550 | 72,187 | 7.6 (7.0–8.3) | Referent | Referent | |||
| <200 cells/mm3 | 326 | 16,597 | 19.6 (17.6–21.9) | 2.6 (2.2–3.0) | <0.001 | 2.11 (1.8–2.5) | <0.001 | |
| Not tested |
2,251 |
537,431 |
4.2 (4.0–4.4) |
0.5 (0.5–0.6) |
<0.001 |
0.58 (0.5-0.7) |
<0.001 |
|
| WHO staging status at ART start | ||||||||
| Stage I | 2,117 | 509,232 | 4.2 (4.0–4.3) | Referent | Referent | |||
| Stage II | 551 | 77,186 | 7.1 (6.6–7.8) | 1.7 (1.5–1.9) | <0.001 | 1.61 (1.5–1.8) | <0.001 | |
| Stage III | 345 | 24,948 | 13.8 (12.4–15.4) | 3.3 (3.0–3.8) | <0.001 | 2.62 (2.3–3.0) | <0.001 | |
| Stage IV | 51 | 4,201 | 12.1 (9.0–16.0) | 2.9 (2.3–3.8) | <0.001 | 1.89 (1.5–2.4) | <0.001 | |
| Not recorded |
63 |
10,649 |
5.9 (4.5–7.6) |
1.4 (1.1–1.9) |
0.01 |
1.29 (1.0–1.7) |
0.06 |
|
| Started TPT within 30 d of ART initiation‡ | ||||||||
| TPT at ART start | 2,569 | 572,983 | 4.5 (4.3–4.7) | Referent | ||||
| Delayed TPT start | 327 | 42,527 | 7.7 (6.9–8.9) | 1.7 (1.5–1.9) | <0.001 | |||
| Not started | 231 | 10,705 | 21.6 (18.9–24.5) | 4.8 (4.0–5.8) | <0.001 | |||
*Incidence is cases/1,000 person-years. IRR, incidence rate ratio, TPT, TB prevention therapy, 3HP, 3-month course of 12 (1/wk) doses of isoniazid and rifapentine. †Suppressed, <1,000 copies/mL; unsuppressed, >1,000 copies/mL. ‡Variable not included in multivariate analysis. §Mozambique’s 11 provinces are categorized into 3 regions: Central (Sofala, Manica, Tete, Zambezia), Northern (Nampula, Niassa, Cabo Delgado), and Southern (Maputo City, Maputo, Gaza, Inhambane).
Page created: February 13, 2026
Page updated: March 20, 2026
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