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. 2016 Nov 1;73(3):e46-e50.
doi: 10.1097/QAI.0000000000001142.

Implementation and Operational Research: Population-Based Active Tuberculosis Case Finding During Large-Scale Mobile HIV Testing Campaigns in Rural Uganda

Emmanuel Ssemmondo  1 , Florence Mwangwa, Joel L Kironde, Dalsone Kwarisiima, Tamara D Clark, Carina Marquez, Edwin D Charlebois, Maya L Petersen, Moses R Kamya, Diane V Havlir, Gabriel Chamie; SEARCH Collaboration
Affiliations

Implementation and Operational Research: Population-Based Active Tuberculosis Case Finding During Large-Scale Mobile HIV Testing Campaigns in Rural Uganda

Emmanuel Ssemmondo et al. J Acquir Immune Defic Syndr. .

Abstract

Background: Active tuberculosis (TB) screening outside clinics and in communities may reduce undiagnosed TB.

Methods: To determine the yield of TB screening during community-based HIV testing campaigns (CHC) in 7 rural Ugandan communities within an ongoing cluster-randomized trial of universal HIV testing and treatment (SEARCH, NCT:01864603), we offered sputum microscopy to participants with prolonged cough (>2 weeks). We determined the number of persons needed to screen to identify one TB case, and the number of cases identified that linked to clinic and completed TB treatment.

Results: Of 36,785 adults enumerated in 7 communities, 27,214 (74%) attended CHCs, and HIV testing uptake was >99%, with 941 (3.5%) HIV-infected adults identified. Five thousand seven hundred eighty-six adults (21%) reported cough and 2876 (11%) reported cough >2 weeks. Staff obtained sputum in 1099/2876 (38%) participants with prolonged cough and identified 10 adults with AFB-positive sputum; 9 new diagnoses and 1 known case already under treatment. The number needed to screen to identify one new TB case was 3024 adults overall: 320 adults with prolonged cough and 80 HIV-infected adults with prolonged cough. All 9 newly diagnosed AFB+ participants were linked to TB care within 2 weeks and were initiated TB treatment.

Conclusions: In a rural Ugandan setting, TB screening as an adjunct to large-scale mobile HIV testing campaigns provides an opportunity to increase TB case detection.

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Conflict of interest statement

Conflicts of Interest: None of the authors have any conflicts of interest.

References

    1. World Health Organization (WHO). Global Tuberculosis Report 2015 Geneva, Switzerland: 2015.
    1. van’t Hoog AH, Laserson KF, Githui WA, et al. High prevalence of pulmonary tuberculosis and inadequate case finding in rural western Kenya. American journal of respiratory and critical care medicine May 1 2011;183(9):1245–1253. - PubMed
    1. Senkoro M, Hinderaker SG, Mfinanga SG, et al. Health care-seeking behaviour among people with cough in Tanzania: findings from a tuberculosis prevalence survey. The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease June 2015;19(6):640–646. - PubMed
    1. Gupta RK, Lucas SB, Fielding KL, Lawn SD. Prevalence of tuberculosis in post-mortem studies of HIV-infected adults and children in resource-limited settings: a systematic review and meta-analysis. AIDS (London, England) August 11 2015. - PMC - PubMed
    1. Buregyeya E, Criel B, Nuwaha F, Colebunders R. Delays in diagnosis and treatment of pulmonary tuberculosis in Wakiso and Mukono districts, Uganda. BMC public health 2014;14:586. - PMC - PubMed

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