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. 2019 Nov 1;23(11):1217-1222.
doi: 10.5588/ijtld.18.0835.

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

V R Rivera  1 , L Lu  2 , O Ocheretina  1 , M A Jean Juste  3 , P Julma  3 , D Archange  3 , C G Moise  3 , F Homeus  3 , P D Phanor  3 , S Petión  3 , P-Y Cremieux  2 , D W Fitzgerald  1 , J W Pape  1 , S P Koenig  4
Affiliations

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

V R Rivera et al. Int J Tuberc Lung Dis. .

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.

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