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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
A simple screening tool for active tuberculosis in HIV-infected adults receiving antiretroviral treatment in Uganda
International Journal of Tuberculosis and Lung Disease, Volume 13, No. 1, Year 2009
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Description
SETTING: Reliable clinical algorithms that screen for active tuberculosis (TB) in human immunodeficiency virus (HIV) infected people initiating or receiving antiretroviral treatment (ART) in sub-Saharan Africa could reduce the need for diagnostic procedures. METHODS: We estimated the utility of six TB-related signs and symptoms, alone or in combination, compared with the Uganda Ministry of Health diagnostic guidelines for participants with prevalent (baseline), early ART (≤3 months on ART) and incident TB (>3 months on ART). RESULTS: Of 1995 participants screened for ART eligibility, 71 (3.6%) had prevalent TB. The presence of any one of the following: cough ≥3 weeks, fever ≥4 weeks, lymphadenopathy or baseline body mass index ≤18 kg/m 2 had a sensitivity of 99% (95% CI 96-100), a specificity of 66% (95% CI 64-68) and a negative predictive value (NPV) of 100% (95% CI 99-100) for predicting active TB. During ART follow-up, TB incidence was 2.4 (95% CI 1.6-3.4)/100 person-years. The presence of cough ≥3 weeks or general weakness was 100% sensitive (95% CI 99-100), 66% specific (95% CI 59-74) and had an NPV of 100% (95% CI 99-100). CONCLUSION: Use of a simple TB screening algorithm can accurately identify, in a resource-poor African setting, HIV-infected individuals who require further procedures to diagnose active TB. © 2009 The Union.
Authors & Co-Authors
Were, Willy A.
Uganda, Entebbe
Cdc-uganda
Uganda, Entebbe
Uganda Virus Research Institute
Moore, David M.
Uganda, Entebbe
Cdc-uganda
Canada, Vancouver
British Columbia Centre for Excellence in Hiv-aids
Canada, Vancouver
The University of British Columbia
Ekwaru, John Paul
Uganda, Entebbe
Cdc-uganda
Mwima, Gerald
Uganda, Entebbe
Cdc-uganda
Bunnell, Rebecca E.
Kenya, Nairobi
Global Aids Program
Kaharuza, Frank M.
Uganda, Entebbe
Cdc-uganda
Rutherford, George Williams
United States, San Francisco
University of California, San Francisco
Mermin, Jonathan H.
Kenya, Nairobi
Global Aids Program
Statistics
Citations: 8
Authors: 8
Affiliations: 6
Identifiers
ISSN:
10273719
Research Areas
Infectious Diseases
Study Design
Cohort Study
Study Locations
Uganda