Impact of TB Culture for HIV-Infected Adults in Brazil
Author Information
Author(s): David W. Dowdy, Maria C. Lourenço, Solange C. Cavalcante, Valeria Saraceni, Bonnie King, Jonathan E. Golub, David Bishai, Betina Durovni, Richard E. Chaisson, Susan E. Dorman
Primary Institution: Johns Hopkins University School of Medicine
Hypothesis
What is the impact and cost-effectiveness of TB culture for diagnosing tuberculosis in HIV-infected individuals in resource-limited settings?
Conclusion
TB culture is potentially effective and cost-effective for HIV-positive patients in resource-constrained settings.
Supporting Evidence
- 33 out of 217 TB suspects had culture-confirmed active tuberculosis.
- TB culture with solid media could avert an estimated 8 TB deaths per 1,000 suspects.
- The cost per DALY averted was estimated at $962 for solid media.
Takeaway
This study shows that testing for tuberculosis using culture can help save lives and is worth the cost, especially for people with HIV in Brazil.
Methodology
The study analyzed costs, laboratory results, and treatment initiation in a centralized TB culture program for HIV-infected patients.
Potential Biases
Potential bias in treatment initiation due to communication failures between labs and clinics.
Limitations
The sample size of confirmed TB cases was small, and the findings may not generalize to other settings.
Participant Demographics
HIV-positive adults presenting with symptoms of pulmonary TB in Rio de Janeiro, Brazil.
Statistical Information
P-Value
0.0001
Confidence Interval
95% simulation interval [4, 15]
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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