Tuberculosis in Antiretroviral Treatment Programs in Lower Income Countries: Availability and Use of Diagnostics and Screening

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dc.contributor.authorFenner, L.
dc.contributor.authorBallif, M.
dc.contributor.authorGraber, C.
dc.contributor.authorNhandu, V.
dc.contributor.authorDusingize, J. C.
dc.contributor.authorCarriquiry, Gabriela
dc.contributor.authorAnastos, Kathryn
dc.contributor.authorGarone, Daniela
dc.contributor.authorJong, Eefje
dc.contributor.authorGnokoro, Joachim Charles
dc.contributor.authorSued, Omar
dc.contributor.authorAjayi, Samuel
dc.contributor.authorDiero, Lameck
dc.contributor.authorWools-Kaloustian, Kara
dc.contributor.authorKiertiburanakul, Sasisopin
dc.contributor.authorCastelnuovo, Barbara
dc.contributor.authorLewden, Charlotte
dc.contributor.authorNicolas, Durier
dc.contributor.authorSterling, Matthias
dc.contributor.authorEgger, Matthias
dc.contributor.authorCortes, Claudia
dc.date.accessioned2024-05-23T15:24:12Z
dc.date.available2024-05-23T15:24:12Z
dc.date.issued2013
dc.description.abstractObjectives: In resource-constrained settings, tuberculosis (TB) is a common opportunistic infection and cause of death in HIV-infected persons. TB may be present at the start of antiretroviral therapy (ART), but it is often under-diagnosed. We describe approaches to TB diagnosis and screening of TB in ART programs in low- and middle-income countries. Methods and findings: We surveyed ART programs treating HIV-infected adults in sub-Saharan Africa, Asia and Latin America in 2012 using online questionnaires to collect program-level and patient-level data. Forty-seven sites from 26 countries participated. Patient-level data were collected on 987 adult TB patients from 40 sites (median age 34.7 years; 54% female). Sputum smear microscopy and chest radiograph were available in 47 (100%) sites, TB culture in 44 (94%), and Xpert MTB/RIF in 23 (49%). Xpert MTB/RIF was rarely available in Central Africa and South America. In sites with access to these diagnostics, microscopy was used in 745 (76%) patients diagnosed with TB, culture in 220 (24%), and chest X-ray in 688 (70%) patients. When free of charge culture was done in 27% of patients, compared to 21% when there was a fee (p = 0.033). Corresponding percentages for Xpert MTB/RIF were 26% and 15% of patients (p = 0.001). Screening practices for active disease before starting ART included symptom screening (46 sites, 98%), chest X-ray (38, 81%), sputum microscopy (37, 79%), culture (16, 34%), and Xpert MTB/RIF (5, 11%). Conclusions: Mycobacterial culture was infrequently used despite its availability at most sites, while Xpert MTB/RIF was not generally available. Use of available diagnostics was higher when offered free of charge.
dc.identifier.citationFenner, L., Ballif, M., Graber, C., Nhandu, V., Dusingize, J. C., Carriquiry, G., ... & Cortes, C. P. (2013). Tuberculosis in antiretroviral treatment programs in lower income countries: Availability and use of diagnostics and screening. PLOS ONE.
dc.identifier.otherDOI: 10.1371/journal.pone.0077697
dc.identifier.urihttps://repositorio.huesped.org.ar/handle/123456789/1064
dc.relation.ispartofseriesPLoS ONE
dc.subjectTuberculosis diagnostics
dc.subjectAntiretroviral treatment
dc.subjectLow-income countries
dc.titleTuberculosis in Antiretroviral Treatment Programs in Lower Income Countries: Availability and Use of Diagnostics and Screening

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