Diagnostic yield of active case finding for tuberculosis at human immunodeficiency virus testing in Haiti

Int J Tuberc Lung Dis. 2019 Nov 1;23(11):1217-1222. doi: 10.5588/ijtld.18.0835.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Chronic Disease
  • Cough / diagnosis
  • Cough / etiology
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / epidemiology
  • Haiti / epidemiology
  • Humans
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification
  • Retrospective Studies
  • Sputum / microbiology
  • Tuberculosis / diagnosis*
  • Tuberculosis / epidemiology
  • Young Adult