Resistance to Mycobacterium tuberculosis infection among highly TB exposed South African gold miners.

<h4>Background</h4>Despite high exposure to Mycobacterium tuberculosis, a small proportion of South African goldminers resist TB infection. We determined, among long-service gold miners i) the proportion who were TB uninfected and ii) epidemiological factors associated with being uninfec...

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Main Authors: Violet N Chihota, Thobani Ntshiqa, Pholo Maenetje, Raoul Mansukhani, Kavindhran Velen, Thomas R Hawn, Robert Wallis, Alison D Grant, Gavin J Churchyard, Katherine Fielding
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0265036&type=printable
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author Violet N Chihota
Thobani Ntshiqa
Pholo Maenetje
Raoul Mansukhani
Kavindhran Velen
Thomas R Hawn
Robert Wallis
Alison D Grant
Gavin J Churchyard
Katherine Fielding
author_facet Violet N Chihota
Thobani Ntshiqa
Pholo Maenetje
Raoul Mansukhani
Kavindhran Velen
Thomas R Hawn
Robert Wallis
Alison D Grant
Gavin J Churchyard
Katherine Fielding
author_sort Violet N Chihota
collection DOAJ
description <h4>Background</h4>Despite high exposure to Mycobacterium tuberculosis, a small proportion of South African goldminers resist TB infection. We determined, among long-service gold miners i) the proportion who were TB uninfected and ii) epidemiological factors associated with being uninfected.<h4>Methods</h4>We enrolled HIV-negative gold miners aged 33-60 years with ≥15 years' service and no history of TB or silicosis. Miners were defined as TB uninfected if i) QuantiFERON-TB Gold Plus (QFT-Plus) negative or ii) in a stricter definition, QFT-Plus-negative and zero-response on TST and as resisters if they were of Black/African ethnicity and negative on both tests. Logistic regression was used to identify epidemiological factors associated with being TB uninfected.<h4>Results</h4>Of 307 participants with a QFT-Plus result, median age was 48 years (interquartile range [IQR] 44-53), median time working underground was 24 years (IQR 18-28), 303 (99%) were male and 91 (30%) were QFT-Plus-negative. The odds of being TB uninfected was 52% lower for unskilled workers (adjusted odds ratio [aOR] 0.48; 95% confidence interval [CI] 0.27-0.85; p = 0.013). Among 281 participants of Black/African ethnicity, 71 (25%) were QFT-Plus negative. Miners with a BMI ≥30 were less likely to be TB uninfected (OR 0.38; 95% CI 0.18-0.80). Using the stricter definition, 44.3% (136/307) of all miners were classified as either TB uninfected (35; 26%) or infected, (101; 74%) and the associations remained similar. Among Black/African miners; 123 were classified as either TB uninfected (23; 19%) or infected (100; 81%) using the stricter definition. No epidemiological factors for being TB uninfected were identified.<h4>Conclusions</h4>Despite high cumulative exposure, a small proportion of miners appear to be resistant to TB infection and are without distinguishing epidemiological characteristics.
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spelling doaj-art-ad63f6d7097b413ab091d62d12df145b2025-08-20T02:22:21ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01173e026503610.1371/journal.pone.0265036Resistance to Mycobacterium tuberculosis infection among highly TB exposed South African gold miners.Violet N ChihotaThobani NtshiqaPholo MaenetjeRaoul MansukhaniKavindhran VelenThomas R HawnRobert WallisAlison D GrantGavin J ChurchyardKatherine Fielding<h4>Background</h4>Despite high exposure to Mycobacterium tuberculosis, a small proportion of South African goldminers resist TB infection. We determined, among long-service gold miners i) the proportion who were TB uninfected and ii) epidemiological factors associated with being uninfected.<h4>Methods</h4>We enrolled HIV-negative gold miners aged 33-60 years with ≥15 years' service and no history of TB or silicosis. Miners were defined as TB uninfected if i) QuantiFERON-TB Gold Plus (QFT-Plus) negative or ii) in a stricter definition, QFT-Plus-negative and zero-response on TST and as resisters if they were of Black/African ethnicity and negative on both tests. Logistic regression was used to identify epidemiological factors associated with being TB uninfected.<h4>Results</h4>Of 307 participants with a QFT-Plus result, median age was 48 years (interquartile range [IQR] 44-53), median time working underground was 24 years (IQR 18-28), 303 (99%) were male and 91 (30%) were QFT-Plus-negative. The odds of being TB uninfected was 52% lower for unskilled workers (adjusted odds ratio [aOR] 0.48; 95% confidence interval [CI] 0.27-0.85; p = 0.013). Among 281 participants of Black/African ethnicity, 71 (25%) were QFT-Plus negative. Miners with a BMI ≥30 were less likely to be TB uninfected (OR 0.38; 95% CI 0.18-0.80). Using the stricter definition, 44.3% (136/307) of all miners were classified as either TB uninfected (35; 26%) or infected, (101; 74%) and the associations remained similar. Among Black/African miners; 123 were classified as either TB uninfected (23; 19%) or infected (100; 81%) using the stricter definition. No epidemiological factors for being TB uninfected were identified.<h4>Conclusions</h4>Despite high cumulative exposure, a small proportion of miners appear to be resistant to TB infection and are without distinguishing epidemiological characteristics.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0265036&type=printable
spellingShingle Violet N Chihota
Thobani Ntshiqa
Pholo Maenetje
Raoul Mansukhani
Kavindhran Velen
Thomas R Hawn
Robert Wallis
Alison D Grant
Gavin J Churchyard
Katherine Fielding
Resistance to Mycobacterium tuberculosis infection among highly TB exposed South African gold miners.
PLoS ONE
title Resistance to Mycobacterium tuberculosis infection among highly TB exposed South African gold miners.
title_full Resistance to Mycobacterium tuberculosis infection among highly TB exposed South African gold miners.
title_fullStr Resistance to Mycobacterium tuberculosis infection among highly TB exposed South African gold miners.
title_full_unstemmed Resistance to Mycobacterium tuberculosis infection among highly TB exposed South African gold miners.
title_short Resistance to Mycobacterium tuberculosis infection among highly TB exposed South African gold miners.
title_sort resistance to mycobacterium tuberculosis infection among highly tb exposed south african gold miners
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0265036&type=printable
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