Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
Tuberculosis in antiretroviral treatment programs in lower income countries: availability and use of diagnostics and screening
Objectives: In resource-constrained settings, tuberculosis (TB) is a common opportunistic infection and cause of death in HIV-infected persons. TB may be present at the start of antiretroviral therapy (ART), but it is often under-diagnosed. We describe approaches to TB diagnosis and screening of TB...
Saved in:
| Format: | Article |
|---|---|
| Published: |
2013
|
| Tags: |
No Tags, Be the first to tag this record!
|
MARC
| LEADER | 00000njm a2000000a 4500 | ||
|---|---|---|---|
| 001 | oai:repository.ui.edu.ng:123456789/10106 | ||
| 042 | |a dc | ||
| 720 | |a Fenner L. |e author | ||
| 720 | |a Ballif M. |e author | ||
| 720 | |a Graber C. |e author | ||
| 720 | |a Nhandu V. |e author | ||
| 720 | |a Dusingize J.C. |e author | ||
| 720 | |a Cortes C.P. |e author | ||
| 720 | |a Carriquiry G. |e author | ||
| 720 | |a Anastos K. |e author | ||
| 720 | |a Garone D. |e author | ||
| 720 | |a Jong, E. |e author | ||
| 720 | |a Gnokoro J.C. |e author | ||
| 720 | |a Sued O. Ajayi S. |e author | ||
| 720 | |a Diero L. |e author | ||
| 720 | |a Wools-Kaloustian K. |e author | ||
| 720 | |a Kiertiburanakul S. |e author | ||
| 720 | |a Castelnuovo B. |e author | ||
| 720 | |a Lewden C. |e author | ||
| 720 | |a Durier, N. |e author | ||
| 720 | |a Sterling T.R. |e author | ||
| 720 | |a Egger M. |e author | ||
| 260 | |c 2013 | ||
| 520 | |a Objectives: In resource-constrained settings, tuberculosis (TB) is a common opportunistic infection and cause of death in HIV-infected persons. TB may be present at the start of antiretroviral therapy (ART), but it is often under-diagnosed. We describe approaches to TB diagnosis and screening of TB in ART programs in low- and middle-income countries. Methods and findings: We surveyed ART programs treating HIV-infected adults in sub-Saharan Africa, Asia and Latin America in 2012 using online questionnaires to collect program-level and patient-level data. Forty-seven sites from 26 countries participated. Patient-level data were collected on 987 adult TB patients from 40 sites (median age 34.7 years; 54% female). Sputum smear microscopy and chest radiograph were available in 47 (100%) sites, TB culture in 44 (94%), and Xpert MTB/RIF in 23 (49%). Xpert MTB/RIF was rarely available in Central Africa and South America. In sites with access to these diagnostics, microscopy was used in 745 (76%) patients diagnosed with TB, culture in 220 (24%), and chest X-ray in 688 (70%) patients. When free of charge culture was done in 27% of patients, compared to 21% when there was a fee (p = 0.033). Corresponding percentages for Xpert MTB/RIF were 26% and 15% of patients (p = 0.001). Screening practices for active disease before starting ART included symptom screening (46 sites, 98%), chest X-ray (38, 81%), sputum microscopy (37, 79%), culture (16, 34%), and Xpert MTB/RIF (5, 11%). Conclusions: Mycobacterial culture was infrequently used despite its availability at most site. | ||
| 024 | 8 | |a PLoS ONE 8(10):Pp.e77697 | |
| 024 | 8 | |a https://repository.ui.edu.ng/handle/123456789/10106 | |
| 245 | 0 | 0 | |a Tuberculosis in antiretroviral treatment programs in lower income countries: availability and use of diagnostics and screening |