Journal of Health Sciences & Surveillance System

Current Issue

By Issue

By Author

By Subject

Author Index

Keyword Index

About Journal

Aims and Scope

Editorial Board

Publication Ethics

Indexing and Abstracting

Related Links

FAQ

Peer Review Process

News

Intensified or Routine Case Finding for Pulmonary Tuberculosis among HIV-Infected Patients: Which is Better?

Document Type : Original Articles

Authors

1 Epidemiology Department, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran.

2 Shiraz HIV/AIDS Center Shiraz University of Medical Sciences

3 Health Center

4 Iranian research center for HIV/AIDS

Abstract

Background: Intensified strategy includes special attention to the symptoms such as cough (more than two weeks), fever (more than three weeks), night sweats (more than three weeks), and weight loss (more than 3 kg per month). If any of the above symptoms was positive, in suspected individuals for TB, more assessment should be done. The aim of this study was to compare between intensified and routine case finding for a better case selection method for diagnosis of pulmonary tuberculosis among HIV-Infected Persons.Methods: The sample size was calculated 237 patients (474 for the two groups). In the current study, the patients were divided randomly into two groups: A) intensified case finding group and B) routine case finding group. Considering the sputum culture as the gold standard, we calculated the sensitivity and specificity, Positive predictive value (PPV), Negative predictive value (NPV) for fever, weight loss, coughing more than two week, night sweats, and PPD test.Result: A total of eight positive cases of tuberculosis were detected in the intensified while four were found in the routine case finding group. Sensitivity, specificity, PPV, and NPV for cough in diagnosis of TB were 25%, 87%, 6%, and 97%, respectively. For weight loss, they were 62.5%, 83%, 10.8%, and 98.5% respectively while these amounts were, 7%, 85%, 97.6, 37.5 for night sweats. For fever, they were, 25%, 92.9%, 10.5%, and 97% respectively, and for PPD they were 87.5%, 40%, 4.6%, and 98.9%, respectively.Conclusion: Key symptom screening, such as cough, fever, weight loss and night sweats, has an important role in detecting TB among HIV-infected patients.

Keywords

References
  1. Jain S, Aggarwal J, Rajpal S, Baveja U. Prevalence of
  2. HIV infection among tuberculosis patients in Delhi-A
  3. sentinel surveillance study. Indian J Tuberc 2000; 47:
  4. -6.
  5. Williams B, Granich R, Chauhan L, Dharmshaktu
  6. N, Dye C. The impact of HIV/AIDS on the control
  7. of tuberculosis in India. Proceedings of the National
  8. Academy of Sciences of the United States of America.
  9. ; 102(27): 9619-24.
  10. Lawn SD, Bekker L-G, Middelkoop K, Myer L, Wood
  11. R. Impact of HIV infection on the epidemiology of
  12. tuberculosis in a peri-urban community in South
  13. Africa: the need for age-specific interventions. Clinical
  14. Infectious Diseases 2006; 42(7): 1040-7.
  15. Collaboration ATC. Incidence of tuberculosis
  16. among HIV-infected patients receiving highly active
  17. antiretroviral therapy in Europe and North America.
  18. Clinical Infectious Diseases 2005; 41(12): 1772-82.
  19. Swaminathan S, Narendran G. HIV and tuberculosis
  20. in India. Journal of biosciences 2008; 33(4): 527-37.
  21. Piramanayagam P, Tahir M, Sharma S, Smith-Rohrberg
  22. D, Biswas A, Vajpayee M. Persistently high HIV
  23. seroprevalence among adult tuberculosis patients at a
  24. tertiary care centre in Delhi. Indian Journal of Medical
  25. Research 2007; 125(2): 163-6.
  26. Seth P. The Situation of HIV/M. tuberculosis
  27. Co-Infection in India. Open Infectious Diseases Journal
  28. ; 5: 51-9.
  29. Havlir DV, Getahun H, Sanne I, Nunn P. Opportunities
  30. and challenges for HIV care in overlapping HIV and
  31. TB epidemics. Jama 2008; 300(4): 423-30.
  32. Getahun H, Harrington M, O’Brien R, Nunn P.
  33. Diagnosis of smear-negative pulmonary tuberculosis
  34. in people with HIV infection or AIDS in resourceconstrained
  35. settings: informing urgent policy changes.
  36. The Lancet 2007; 369(9578): 2042-9.
  37. Currie CS, Williams BG, Cheng RC, Dye C.
  38. Tuberculosis epidemics driven by HIV: is prevention better than cure? Aids 2003; 17(17): 2501-8.
  39. Srikantiah P, Charlebois E, Havlir DV. Rapid increase
  40. in tuberculosis incidence soon after infection with
  41. HIV-a new twist in the twin epidemics. Journal of
  42. Infectious Diseases 2005; 191(2): 147-9.
  43. Girardi E1, Sabin CA, d’Arminio Monforte A, Hogg B,
  44. Phillips AN, Gill MJ, et al. Incidence of Tuberculosis
  45. among HIV-Infected Patients Receiving Highly Active
  46. Antiretroviral Therapy in Europe and North America.
  47. HIV/AIDS 2005; 41: 1772-82.
  48. Moodley Y. The interaction of HIV and tuberculosis.
  49. infection 2008; 11: 289-99.
  50. Mahmood SAI. TB and HIV/AIDS in Bangladesh. J
  51. AIDS HIV Res 2010; 2(4): 66-78.
  52. Anandaiah A, Dheda K, Keane J, Koziel H, Moore
  53. DA, Patel NR. Novel developments in the epidemic
  54. of human immunodeficiency virus and tuberculosis
  55. coinfection. American journal of respiratory and
  56. critical care medicine 2011; 183(8): 987.
  57. Padmapriyadarsini C, Narendran G, Swaminathan
  58. S. Diagnosis & treatment of tuberculosis in HIV
  59. co-infected patients. The Indian journal of medical
  60. research 2011; 134(6): 850.
  61. Vitoria M, Granich R, Gilks CF, Gunneberg C, Hosseini
  62. M, Were W, et al. The global fight against HIV/AIDS,
  63. tuberculosis, and malaria current status and future
  64. perspectives. American journal of clinical pathology
  65. ; 131(6): 844-8.
  66. Alimohamadi Y, Tabatabaee H, Afsar Kazerooni P,
  67. Vahedi S, Enaami M, Teimourizad A. Epidemiologic
  68. characteristics of HIV-positive patients referring to
  69. behavioral diseases consultation center in Shiraz,
  70. Iran. Medical Journal of The Islamic Republic of Iran
  71. (MJIRI) 2014; 28: 140-7.
  72. Rasoulinejad M, Bouyer M, Emadi Kouchak M,
  73. Hasibi M, Mollazadeh N, Moradmand badie B. Druginduced
  74. complications of anti-tuberculosis drugs in
  75. HIV patients. Tehran University Medical Journal 2011;
  76. (10): 611-17.
  77. Giehl C, Roy RB, Knellwolf A-L. The situation of
  78. HIV/M. tuberculosis co-infection in Europe. Open
  79. Infectious Diseases Journal 2011; 5: 21-35.
  80. Cain KP, McCarthy KD, Heilig CM, Monkongdee P,
  81. Tasaneeyapan T, Kanara N, et al. An algorithm for
  82. tuberculosis screening and diagnosis in people with
  83. HIV. New England Journal of Medicine 2010; 362(8): 707-16.
  84. Shah S, Demissie M, Lambert L, Ahmed J, Leulseged
  85. S, Kebede T, et al. Intensified tuberculosis case finding
  86. among HIV-Infected persons from a voluntary
  87. counseling and testing center in Addis Ababa, Ethiopia.
  88. JAIDS Journal of Acquired Immune Deficiency
  89. Syndromes 2009; 50(5): 537-45
  90. Alvarez MA, Arbelaez P, Bastos FIPM, Berkhout B,
  91. Bhattacharya B, Bocharov G, et al. Research priorities
  92. for HIV/M. tuberculosis co-infection 2011; 5(Suppl
  93. -M2): 14-20.
  94. World Health Organisation: Three I’s Meeting:
  95. Intensified Case Finding(ICF), Isoniazid Preventive
  96. Therapy (IPT) and TB Infection Control (IC) forpeople
  97. living with HIV. WHO HIV/AIDS and TB Department
  98. Three I’s MeetingReport Geneva, Switzerland, WHO;
  99. Hermans S, Nasuuna E, van Leth F, Byhoff E, Schwarz
  100. M, Hoepelman A, et al. Implementation and effect of
  101. intensified case finding on diagnosis of tuberculosis
  102. in a large urban HIV clinic in Uganda: a retrospective
  103. cohort study. BMC public health 2012; 12(1): 674.
  104. Nasehi M, Mirhaghani L. Ntionalguidline contend
  105. against tuberculosis. 2 ed. Tehran: Andishmand; 2010.
  106. Elden S, Lawes T, Vandelanotte J. Integrating intensify
  107. case finding of tuberculosis into HIV care :an evaluation
  108. from rural Swaziland. BMC Health Services Reaserch
  109. ; 11(118): 3-7.
  110. Taye T, Sturega E, Winqvist N, Skogma S, Reepalu
  111. A, Habtamu Jemal Z, et al. Intensified Tuberculosis
  112. Case-Finding in HIV-Positive Adults Managed at
  113. Ethiopian Health Centers: Diagnostic Yield of X pert
  114. MTB/RIF Compared with Smear Microscopy and
  115. Liquid Culture. PLOS ONE 2014; 9(1): 1-11.
  116. Hermans S, Nasuuna E, Van Leth F, Byoff E, Schwarz
  117. M, Hoepelman A, et al. Implementation and effect of
  118. intensified case finding on diagnosis of tuberculosis
  119. in a large urban HIV clinic in Uganda: a retrospective
  120. cohort study. BMC Public Health 2012; 12(674): 1-9.
  121. Dhungana GP, Ghimire P, Sharma S, Rijal BP. Intensified
  122. Case Finding of Active Pulmonary Tuberculosis (TB)
  123. Among HIV Positive Persons in Kathmandu. Journal
  124. of Nepal Health Research Council 2008; 5(1): 11-16.
  125. Cain KP, McCarthy KD, Heilig CM, Monkongdee P,
  126. Tasaneeyapan T, Kanara N, et al. An Algorithm for
  127. Tuberculosis Screening and Diagnosis in People with
  128. HIV. N Engl J Med 2010; 362(8): 707-16.
Journal of Health Sciences & Surveillance System
Volume 3, Issue 1 - Serial Number 1
9
January 2015
Pages 13-19
Files
Share
How to cite
Statistics