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dc.contributor.authorNagu, Tumaini J.en_US
dc.contributor.authorSpiegelman, Donnaen_US
dc.contributor.authorHertzmark, Ellenen_US
dc.contributor.authorAboud, Saiden_US
dc.contributor.authorMakani, Julieen_US
dc.contributor.authorMatee, Mecky I.en_US
dc.contributor.authorFawzi, Wafaieen_US
dc.contributor.authorMugusi, Ferdinanden_US
dc.date.accessioned2014-04-11T14:10:53Z
dc.date.issued2014en_US
dc.identifier.citationNagu, Tumaini J., Donna Spiegelman, Ellen Hertzmark, Said Aboud, Julie Makani, Mecky I. Matee, Wafaie Fawzi, and Ferdinand Mugusi. 2014. “Anemia at the Initiation of Tuberculosis Therapy Is Associated with Delayed Sputum Conversion among Pulmonary Tuberculosis Patients in Dar-es-Salaam, Tanzania.” PLoS ONE 9 (3): e91229. doi:10.1371/journal.pone.0091229. http://dx.doi.org/10.1371/journal.pone.0091229.en
dc.identifier.issn1932-6203en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:12064366
dc.description.abstractBackground: Pulmonary tuberculosis and anemia are both prevalent in Tanzania. There is limited and inconsistent literature on the association between anemia and sputum conversion following tuberculosis treatment. Methods: Newly diagnosed sputum smear positive pulmonary tuberculosis patients aged ≥15 years initiating on standard anti tuberculosis therapy were recruited from 14 of 54 tuberculosis clinics in Dar es Salaam. Patients were receiving medication according to the recommended short course Directly Observed Therapy (DOT) strategy and were followed up prospectively until completion of treatment (six months). Patients were evaluated before initiation of TB treatment by performing the following; clinical history, physical examination, complete blood counts, serum biochemistry and sputum microscopy. Sputum smears were re-examined at two months of anti-tuberculosis therapy for presence of acid fast bacilli. Anemia was defined as hemoglobin <13 g/dl (males) or <12 g/dl (females). Log-binomial regression was used to assess the association between anemia and sputum conversion at two months. Results: Of the 1245 patients included in the study, 86% were anemic and 7% were sputum smear positive at two months of anti-tuberculosis therapy. Anemic patients were three times more likely to have sputum positive smear as compared to non-anemic patients at two months (RR = 3.05; 95% CI 1.11–8.40) p = 0.03. The risk for sputum positive smear results increased with severity of anemia (P for trend <0.01). Conclusion: Baseline anemia is associated with increased risk for persistent positive sputum smears at two months of tuberculosis treatment. Future studies should evaluate the mechanisms for TB-associated anemia as well as the role of intervention for anemia among TB patients.en
dc.language.isoen_USen
dc.publisherPublic Library of Scienceen
dc.relation.isversionofdoi:10.1371/journal.pone.0091229en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3958362/pdf/en
dash.licenseLAAen_US
dc.subjectBiology and Life Sciencesen
dc.subjectMicrobiologyen
dc.subjectMedical Microbiologyen
dc.subjectMicrobial Pathogensen
dc.subjectBacterial Pathogensen
dc.subjectMycobacteriaen
dc.subjectMedicine and Health Sciencesen
dc.subjectEpidemiologyen
dc.subjectClinical Epidemiologyen
dc.subjectHematologyen
dc.subjectAnemiaen
dc.subjectInfectious Diseasesen
dc.subjectBacterial Diseasesen
dc.subjectTuberculosisen
dc.subjectPublic and Occupational Healthen
dc.subjectGlobal Healthen
dc.subjectTropical Diseasesen
dc.subjectClinical Research Designen
dc.subjectProspective Studiesen
dc.titleAnemia at the Initiation of Tuberculosis Therapy Is Associated with Delayed Sputum Conversion among Pulmonary Tuberculosis Patients in Dar-es-Salaam, Tanzaniaen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalPLoS ONEen
dash.depositing.authorSpiegelman, Donnaen_US
dc.date.available2014-04-11T14:10:53Z
dc.identifier.doi10.1371/journal.pone.0091229*
dash.contributor.affiliatedHertzmark, Ellen
dash.contributor.affiliatedSpiegelman, Donna
dash.contributor.affiliatedFawzi, Wafaie
dc.identifier.orcid0000-0003-4006-4650
dc.identifier.orcid0000-0002-2908-600X


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