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Symptom-based Screening Tool in Ruling Out Active Tuberculosis among HIV-Infected Patients Eligible for Isoniazid Preventive Therapy in Tanzania.

Shayo, G. A., Minja, L. T., Egwaga, S., Bakari, M. and Mugusi, F. M. (2014) Symptom-based Screening Tool in Ruling Out Active Tuberculosis among HIV-Infected Patients Eligible for Isoniazid Preventive Therapy in Tanzania. Tropical medicine & international health : TM & IH, 19 (6). pp. 726-733. ISSN 1365-3156

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Abstract

We assessed the usefulness of the National TB and Leprosy Control Program (NTLP) symptom-based tuberculosis (TB) screening tool in identifying HIV-infected patients eligible for isoniazid preventive therapy in Muhimbili National Hospital, Dar es Salaam Tanzania. Descriptive cross-sectional study. Data collected included socio-demographic and clinical data. Chest X-ray, sputum for acid-fast bacilli (AFB) microscopy, mycobacterial culture, CD4 + count and complete blood count were performed. Patients were considered not having active TB if they presented with no symptom in the screening tool, which comprised these symptoms: cough, fever and excessive night sweats for ≥2 weeks; weight loss of ≥3 kg in 4 weeks and haemoptysis of any duration. The reference standard was a negative culture for Mycobacterium tuberculosis. We enroled 373 patients, of whom 72.1% were females. Active pulmonary TB was found in 4.1% (14/338) of the participants as defined by a positive culture. The sensitivity and specificity of the NTLP screening tool were 71.4% (10/14) and 75.9% (246/324), respectively. False-negative rate was 28.6% (4/10). Cough, fever for ≥2 weeks and weight loss were independent predictors of NTLP-defined TB. Cough ≥2 weeks predicted TB when a positive culture was used to define TB. The screening tool had fairly good sensitivity and specificity for TB screening; however, there is a possibility that about 29% of the screened population will be given IPT while they are supposed to receive a full course of TB treatment.

Item Type: Article
Keywords: sensitivity, specificity, negative predictive value, tuberculin skin test, NTLP screening tool
Subjects: Tuberculosis > Surveillance
Tuberculosis > Diagnosis
Divisions: Muhimbili University of Health and Allied Sciences (MUHAS)
Depositing User: Mr Joseph Madata
Date Deposited: 02 Mar 2016 09:05
Last Modified: 02 Mar 2016 09:05
URI: http://ihi.eprints.org/id/eprint/3642

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