Published in PLOS One on 2026-04-07, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Jackline Anase Nlula, Sembakutti Samita, Etienne Yuh Jam, Bernard Ngowi, Ellen Mitchell, Anthony Enimil
Source: PLOS One • DOI 10.1371/journal.pone.0346249
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
The Geita Region of Tanzania is known as critical focal point for tuberculosis (TB) control due to its persistently high disease burden and unique socio-economic landscape. Despite this, limited research has explored how sociodemographic and clinical factors influence TB presentation (pulmonary versus extrapulmonary) and successful treatment outcome. This study aimed to identify these factors within this community to inform targeted interventions. We conducted a retrospective cohort study of TB cases aged 15 years and above, who were notified in Geita Region from January 2017 to December 2020. Data were obtained from the national TB program registers, and included sociodemographic, clinical, and treatment information. The primary outcomes were TB presentation (Pulmonary vs. Extrapulmonary) and treatment outcome, categorized as successful (a composite of “cured” and “treatment completed”) or unsuccessful (death, failure, and loss to follow-up). Multivariable binary logistic regression was applied to assess associations with TB presentation and treatment outcomes, including potential interaction effects between factors. Statistical analyses were performed using SAS OnDemand for initial data cleaning, and Stata 17.0 for all statistical modeling. A total of 13,107 TB cases were included, of which 12,032 (91.9%) pulmonary TB and 1,058 (8.1%) extrapulmonary TB. Logistic regression showed workplace significantly associated with presentation: prisoners had lower odds of pulmonary TB compared to miners (OR 0.26, 95% CI 0.12–0.58). Community-referred cases had higher odds of pulmonary TB than self-referred cases (OR 1.24, 95% CI 1.06–1.45). New TB cases had lower odds of pulmonary TB compared with relapse (OR 0.33, 95% CI 0.15–0.75). Age × sex and HIV × sex interactions associated with differential presentation risks. Treatment success was achieved in 12,385 patients (95.5%), while 581 (4.5%) experienced unsuccessful outcomes. Predictors of successful treatment included age < 60 years (OR 1.31, 95% CI 1.05–1.65), new TB status (OR 2.45, 95% CI 1.53–3.93), and HIV-negative status (OR 1.90, 95% CI 1.53–2.37). Workplace, referral source, and HIV status significantly influence TB presentation and treatment outcomes. Implementation targeted interventions, including strengthened occupational health policies, enhanced community-based screening, and focused strategies for high-risk groups is essential to improving TB control in Tanzania.
Introduction
Tuberculosis (TB) remains one of the world’s deadliest infectious diseases, despite being curable. In 2024, TB caused approximately 1.23 million deaths globally, highlighting its ongoing threat to public health [1]. The disease burden is particularly severe in Sub-Saharan Africa (SSA), which accounts for over 25% of global TB cases and reports the highest rates of HIV-associated Tanzania is classified among the 30 high-burden TB countries, with an estimated incidence of 183 cases per 100,000 population in 2023 [2]. Many countries, including Tanzania, continue to encounter significant obstacles in TB control. While global initiatives have reduced TB incidence in certain regions, persistent challenges, such as treatment failure and ongoing transmission, persist [3]. These factors impede national progress toward achieving the World Health Organization’s End TB Strategy, which seeks to substantially reduce TB incidence and mortality by 2030 [4].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider financing & policy desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Jackline Anase Nlula, Sembakutti Samita, Etienne Yuh Jam, Bernard Ngowi, Ellen Mitchell, Anthony Enimil. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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