SETTING: A large, urban human immunodeficiency virus (HIV) voluntary counseling and testing (VCT) center in Kampala, Uganda. OBJECTIVE: Tuberculosis (TB) is a leading cause of morbidity and mortality in persons with HIV infection in sub-Saharan Africa. Intensified TB case finding and use of isoniazid preventive therapy (IPT) for latent infection reduces the burden of TB, but few programs have been implemented due to concerns about feasibility. DESIGN: Retrospective evaluation of a TB case finding and IPT program. RESULTS: Over a 25-month period, 6305 patients newly diagnosed with HIV infection underwent evaluation: 293 (5%) had TB disease; 1955 (37%) patients were not eligible for preventive therapy because they lived > 20 km away, had advanced HIV disease, or had previously had TB. Of 3366 who had a tuberculin skin test (TST) placed, 2548 (76%) had the TST read; 894 (35%) of these were positive. Of 506 persons who started treatment, 335 (66%) completed it. CONCLUSION: This unique program was feasible, detected a high proportion of undiagnosed TB, and successfully treated persons with latent infection. Expanding access to HIV VCT as well as collaboration between HIV/ AIDS and TB programs can increase the proportion of HIV-infected persons who can benefit from these programs.
SETTING: A large, urban human immunodeficiency virus (HIV) voluntary counseling and testing (VCT) center in Kampala, Uganda. OBJECTIVE:Tuberculosis (TB) is a leading cause of morbidity and mortality in persons with HIV infection in sub-Saharan Africa. Intensified TB case finding and use of isoniazid preventive therapy (IPT) for latent infection reduces the burden of TB, but few programs have been implemented due to concerns about feasibility. DESIGN: Retrospective evaluation of a TB case finding and IPT program. RESULTS: Over a 25-month period, 6305 patients newly diagnosed with HIV infection underwent evaluation: 293 (5%) had TB disease; 1955 (37%) patients were not eligible for preventive therapy because they lived > 20 km away, had advanced HIV disease, or had previously had TB. Of 3366 who had a tuberculin skin test (TST) placed, 2548 (76%) had the TST read; 894 (35%) of these were positive. Of 506 persons who started treatment, 335 (66%) completed it. CONCLUSION: This unique program was feasible, detected a high proportion of undiagnosed TB, and successfully treated persons with latent infection. Expanding access to HIV VCT as well as collaboration between HIV/ AIDS and TB programs can increase the proportion of HIV-infectedpersons who can benefit from these programs.
Authors: Khai Hoan Tram; Florence Mwangwa; Gabriel Chamie; Mucunguzi Atukunda; Asiphas Owaraganise; James Ayieko; Vivek Jain; Tamara D Clark; Dalsone Kwarisiima; Maya L Petersen; Moses R Kamya; Edwin D Charlebois; Diane V Havlir; Carina Marquez Journal: AIDS Care Date: 2019-06-10
Authors: A C Tribble; C D Hamilton; J A Crump; A Mgonja; A Mtalo; E Ndanu; D K Itemba; K Z Landman; M Shorter; E M Ndosi; J F Shao; J A Bartlett; N M Thielman Journal: Int J Tuberc Lung Dis Date: 2009-10 Impact factor: 2.373
Authors: Katharina Kranzer; Rein Mgj Houben; Judith R Glynn; Linda-Gail Bekker; Robin Wood; Stephen D Lawn Journal: Lancet Infect Dis Date: 2010-02 Impact factor: 25.071
Authors: Andrew D Kerkhoff; Katharina Kranzer; Taraz Samandari; Jessica Nakiyingi-Miiro; Christopher C Whalen; Anthony D Harries; Stephen D Lawn Journal: PLoS One Date: 2012-11-27 Impact factor: 3.240