HIV and Tuberculosis Screening in Resource-Limited Settings
Author Information
Author(s): Kranzer Katharina, Houben Rein MGJ, Glynn Judith R, Bekker Linda-Gail, Wood Robin, Lawn Stephen D
Primary Institution: The Desmond Tutu HIV Centre, University of Cape Town
Hypothesis
Does intensified case finding improve the detection of HIV-associated tuberculosis in resource-limited settings?
Conclusion
Intensified case finding significantly increases the detection of tuberculosis among individuals infected with HIV, especially when all individuals are screened microbiologically without preselection.
Supporting Evidence
- Median prevalence of newly diagnosed tuberculosis was 0.7% in population-based surveys and up to 8.5% in voluntary counselling and testing services.
- Microbiological sputum examination yielded an additional four cases per 100 individuals screened.
- Intensified case finding identified a high yield of tuberculosis cases among individuals infected with HIV.
Takeaway
This study shows that regularly checking people with HIV for tuberculosis can find many more cases, especially if everyone is tested, not just those who show symptoms.
Methodology
Systematic review and meta-analysis of studies on intensified case finding for tuberculosis in HIV-infected individuals.
Potential Biases
Potential bias due to variable uptake of eligible individuals and lack of quality control in some studies.
Limitations
Data on treatment outcomes and cost-effectiveness were lacking, and there was variability in participant agreement rates across studies.
Participant Demographics
Studies included various populations, primarily from sub-Saharan Africa, with a focus on individuals infected with HIV.
Statistical Information
P-Value
0.03
Confidence Interval
95% CI not provided
Statistical Significance
p=0.03
Digital Object Identifier (DOI)
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