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Symptom‐based screening tool in ruling out active tuberculosis among HIV ‐infected patients eligible for isoniazid preventive therapy in T anzania
Author(s) -
Shayo Grace A.,
Minja Lilian T.,
Egwaga Said,
Bakari Muhammad,
Mugusi Ferdinand M.
Publication year - 2014
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12307
Subject(s) - medicine , tuberculosis , isoniazid , sputum , sputum culture , mycobacterium tuberculosis , population , tanzania , rifampicin , weight loss , immunology , pathology , environmental health , environmental science , environmental planning , obesity
Objectives We assessed the usefulness of the National TB and Leprosy Control Program ( NTLP ) symptom‐based tuberculosis ( TB ) screening tool in identifying HIV ‐infected patients eligible for isoniazid preventive therapy in Muhimbili National Hospital, Dar es Salaam Tanzania. Methods Descriptive cross‐sectional study. Data collected included socio‐demographic and clinical data. Chest X‐ray, sputum for acid‐fast bacilli ( AFB ) microscopy, mycobacterial culture, CD 4 + count and complete blood count were performed. Patients were considered not having active TB if they presented with no symptom in the screening tool, which comprised these symptoms: cough, fever and excessive night sweats for ≥2 weeks; weight loss of ≥3 kg in 4 weeks and haemoptysis of any duration. The reference standard was a negative culture for M ycobacterium tuberculosis . Results We enroled 373 patients, of whom 72.1% were females. Active pulmonary TB was found in 4.1% (14/338) of the participants as defined by a positive culture. The sensitivity and specificity of the NTLP screening tool were 71.4% (10/14) and 75.9% (246/324), respectively. False‐negative rate was 28.6% (4/10). Cough, fever for ≥2 weeks and weight loss were independent predictors of NTLP ‐defined TB . Cough ≥2 weeks predicted TB when a positive culture was used to define TB . Conclusion The screening tool had fairly good sensitivity and specificity for TB screening; however, there is a possibility that about 29% of the screened population will be given IPT while they are supposed to receive a full course of TB treatment.