Open AccessDiagnostic yield of active case finding for tuberculosis at human immunodeficiency virus testing in Haiti
Author(s) -
Vanessa Rivera,
Liuzhu Lu,
Oksana Ocheretina,
Marc Antoine Jean Juste,
Pierrot Julma,
D Archange,
Colette Guiteau Moise,
Fabienne Homeus,
P D Phanor,
S Petión,
P-Y Cremieux,
Daniel W. Fitzgerald,
Jean William Pape,
Serena P. Koenig
Publication year - 2019
Publication title -
the international journal of tuberculosis and lung disease/the international journal of tuberculosis and lung disease. articles traduits en français ...
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.103
H-Index - 110
eISSN - 1815-7920
pISSN - 1027-3719
DOI - 10.5588/ijtld.18.0835
Subject(s) - medicine , tuberculosis , sputum , human immunodeficiency virus (hiv) , cohort , chronic cough , retrospective cohort study , case finding , immunology , pathology , asthma
SETTING: The Groupe Haïtien d'étude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) Centres, Port-au-Prince, Haiti, facilitate "test and treat" strategies by screening all patients for tuberculosis (TB) at human immunodeficiency virus (HIV) testing. OBJECTIVE: 1) To determine the proportion of patients with chronic cough at HIV testing diagnosed with TB, stratified by HIV test results; and 2) to evaluate the additional diagnostic yield of Xpert ® MTB/RIF vs. sputum microscopy. DESIGN: We conducted a retrospective cohort analysis including all adults tested for HIV at GHESKIO from August 2014 to July 2015. RESULTS: Of 29 233 adult patients tested for HIV, 2953 (10%) were diagnosed as HIV-positive. Chronic cough lasting ≥2 weeks was reported by 1116 (38%) HIV-positive patients; 984 (88%) were tested and 265 (27%) were diagnosed with TB. Chronic cough was reported by 5985 (23%) HIV-negative patients; 5654 (94%) were tested and 1179 (21%) were diagnosed with TB. Of all bacteriologically confirmed cases, 27% were smear-negative and Xpert-positive. Among all TB patients, 81% were HIV-negative. CONCLUSIONS: Screening for TB at HIV testing was high-yield, among both HIV-infected and HIV-negative individuals. Testing for both diseases should be conducted among patients who present with chronic cough at HIV testing.