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Screening for active tuberculosis in HIV testing centre

M A Espinal1, A L Reingold, E Koenig

  • 1Division of Public Health Biology and Epidemiology, School of Public Health, University of California, Berkeley, USA.

Lancet (London, England)
|April 8, 1995
PubMed
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Screening for tuberculosis (TB) at HIV testing sites can effectively detect active TB in both HIV-positive and HIV-negative individuals. This integrated approach aids early diagnosis and treatment, reducing TB transmission.

Area of Science:

  • Public Health
  • Infectious Diseases
  • Epidemiology

Background:

  • Standard tuberculosis (TB) screening and isoniazid prophylaxis are not feasible in many developing countries.
  • Integrating TB screening into HIV testing offers a potential solution for early detection.

Purpose of the Study:

  • To evaluate the effectiveness of screening for active TB at HIV testing centers in the Dominican Republic.
  • To identify predictors of active TB among individuals seeking HIV testing.

Main Methods:

  • A comparative study involving 200 newly detected HIV-positive and 200 age/sex-matched HIV-negative individuals.
  • Offered skin testing and brief clinical examination for active TB at an HIV testing center.
  • Multivariate analysis to identify independent predictors of active TB.
Keywords:
Acquired Immunodeficiency SyndromeAmericasCaribbeanDeveloping CountriesDiseasesDominican RepublicExaminations And DiagnosesHiv InfectionsHiv SerodiagnosisInfectionsLaboratory Examinations And DiagnosesLatin AmericaNorth AmericaPhysical Examinations And DiagnosesResearch ReportScreeningTreatmentTuberculosisViral Diseases

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Main Results:

  • 9.7% of 400 individuals seeking HIV testing had active TB; 29 were HIV-positive and 10 were HIV-negative.
  • Strongest predictors of active TB included 10mm+ skin test induration, chronic cough, lymphadenopathy, and HIV infection.
  • 85% of TB patients had symptoms identifiable through a brief screening questionnaire.

Conclusions:

  • Screening for TB at HIV testing sites is an effective strategy for early detection of active TB in both HIV-positive and HIV-negative populations.
  • Integrating TB screening into HIV testing schemes can reduce TB spread and facilitate earlier patient diagnosis and treatment.