Risk factors for pulmonary disease due to culture-positive M. tuberculosis or nontuberculous mycobacteria in South African gold miners.

Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.

Risk factors for pulmonary disease due to culture-positive M. tuberculosis or nontuberculous mycobacteria in South African gold miners.

Eur Respir J. 2000 Feb;15(2):291-6. Unique Identifier : AIDSLINE MED/20169011
Sonnenberg P; Murray J; Glynn JR; Thomas RG; Godfrey-Faussett P; Shearer S; Dept of Infectious and Tropical Diseases, London School of; Hygiene and Tropical Medicine, UK.

Abstract: The aim of this study was to determine risk factors for disease due to nontuberculous mycobacteria (NTM) compared to those due to Mycobacterium tuberculosis in South African gold miners with pulmonary mycobacterial disease. A case/control study comparing tuberculosis and NTM cases amongst all patients with a positive sputum mycobacterial culture in 1995 was carried out. The 51 cases of disease due to NTM and 425 tuberculosis cases were similar with regard to age, education, home region, smoking habits and percentage of CD4 cells. After adjustment for confounders, those with NTM were more likely to have had previous tuberculosis treatment (odds ratio (OR) 3.61; 95% confidence interval (CI) 1.9-6.9), have worked longer underground (p-value for trend=0.05) or have evidence of silicosis (OR 12.6; 95% CI 2.2-71) and were less likely to drink regularly (OR 0.12; 95% CI 0.02-0.93) than patients with tuberculosis. In patients with disease due to NTM, 35.3% were human immunodeficiency virus-positive compared with 48.8% of tuberculosis patients (p=0.2) and an estimated 21% overall in the mines at the time of the study. Previous tuberculosis treatment, silicosis and duration of underground work are even more strongly associated with disease due to nontuberculous mycobacteria than with tuberculosis. Attempts to reduce the incidence of all pulmonary mycobacterial disease in this community should address recognized risk factors and ensure that those with tuberculosis are diagnosed, treated and cured.

Keywords: JOURNAL ARTICLE Adult Case-Control Studies Gold Human HIV Seropositivity Lung Diseases/EPIDEMIOLOGY/*MICROBIOLOGY Male Mining Mycobacteria, Atypical/ISOLATION & PURIF Mycobacterium tuberculosis/ISOLATION & PURIF Mycobacterium Infections, Atypical/*EPIDEMIOLOGY Risk Factors Silicosis/EPIDEMIOLOGY South Africa/EPIDEMIOLOGY Sputum/MICROBIOLOGY Time Factors Tuberculosis, Pulmonary/*EPIDEMIOLOGY

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