Routine Ultrasonography for Intensified Tuberculosis Case Finding in High Human Immunodeficiency Virus (HIV) and...

Area of Science:

• Medical Imaging
• Infectious Diseases
• Public Health

Background:

• Coinfection with HIV/AIDS and tuberculosis (TB) presents diagnostic challenges, particularly in resource-limited settings.
• Access to advanced diagnostic imaging is often scarce in these regions, hindering timely patient management.

Purpose of the Study:

• To review the utility of sonography (ultrasound) in diagnosing extrapulmonary tuberculosis (EPTB) in patients with HIV/AIDS.
• To assess the feasibility and impact of point-of-care ultrasound (POCUS) in resource-constrained environments for managing coinfections.

Main Methods:

• A comprehensive literature search was conducted for English-language, peer-reviewed articles from 1994-2021.
• Databases searched included MEDLINE, PubMed, POPLINE, Scopus, and Google Scholar, supplemented by gray literature.
• Emerging themes were identified through recurrence in the literature.

Main Results:

• Ultrasound is a rapid, accurate diagnostic tool for identifying pathological findings like enlarged lymph nodes, pericarditis, and pleural effusion in HIV/AIDS and TB coinfected patients.
• Sonography is cost-effective, portable, and user-friendly, enabling imaging services in underserved clinical settings.
• The Focused Assessment with Sonography for HIV (FASH) protocol facilitates prompt diagnosis of EPTB.

Conclusions:

• Implementing POCUS, specifically the FASH protocol, can significantly improve the diagnosis and treatment of undifferentiated TB in high-prevalence HIV/AIDS and TB coinfection regions.
• Training and deploying sonographers in endemic areas for EPTB diagnosis aligns with global health initiatives to end epidemics and achieve universal health coverage.