Important note: Information in this article was accurate in February 2009. The state of the art may have changed since the publication date.
AIDSWEEKLY Plus; Monday, February 16, 2009
Staff Medical Writers
NewsRx -- According to recent research from Entebbe, Uganda, "Reliable clinical algorithms that screen for active tuberculosis (TB) in human immunodeficiency virus (HIV) infected people initiating or receiving anti-retroviral treatment (ART) in sub-Saharan Africa could reduce the need for diagnostic procedures. 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)."
"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/m2 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)," wrote W. Were and colleagues, Centers for Disease Control and Prevention (see also HIV/AIDS Co-Infection).
The researchers concluded: "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."
Were and colleagues published their study in International Journal of Tuberculosis and Lung Disease (A simple screening tool for active tuberculosis in HIV-infected adults receiving antiretroviral treatment in Uganda. Int J Tuberc Lung Dis. 2009 Jan;13(1):47-53.
For additional information, contact W. Were, CDC Uganda, Uganda Virus Research Institute, Global AIDS Program, POB 49, Entebbe, Uganda.
Publisher contact information for the International Journal of Tuberculosis and Lung Disease is: International Union Against Tuberculosis Lung Disease (I U a T L D), 68 Boulevard Saint-Michel, 75006 Paris, France.
Keywords: Uganda, Entebbe, HIV/AIDS Co-Infection, AIDS, Acquired Immune Deficiency Syndrome, Acquired Immunodeficiency Syndrome, Antivirals, Cutaneous Tuberculosis, Diagnostics, HIV, Human Immunodeficiency Virus Bacterial Infection, Immunology, Infectious Disease, Lung Disease, Mycobacteria, Mycobacterium Tuberculosis, Regulatory Actions, Sexually Transmitted Disease, Viral, Virology, Centers for Disease Control and Prevention.
This article was prepared by AIDS Weekly editors from staff and other reports.
Ref: Were W. et al., “A simple screening tool for active tuberculosis in HIV-infected adults receiving antiretroviral treatment in Uganda”, Int J Tuberc Lung Dis. 2009 Jan;13(1):47-53.
2009-02-16
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