Serial Clinical Screening for Active Tuberculosis among HIV-infected Kenyan Adults
Journal Title: Journal of Advances in Medicine and Medical Research - Year 2014, Vol 4, Issue 29
Abstract
Setting: Urban, non-governmental HIV outpatient clinic in Mombasa, Kenya. Objective: To report outcomes and assess feasibility of serial clinical screening for active TB among adults enrolled in outpatient HIV care in a resource-limited setting. Design: Longitudinal analysis of screening conducted during routine clinic visits of HIV-infected Kenyan adults. The provider-initiated screen included TB symptom assessment and targeted physical exam. Participants with >1 symptom/sign were to submit sputum for microscopy and undergo chest radiography. Results: Over 33 months, 4,854 HIV-infected outpatients were serially screened for active TB at a median interval of 3 months. Treatment for active TB was started in 127 (2.6%). Of those 127, 77 (60.6%) were diagnosed based on first screen, and 50 (39.4%) were diagnosed thereafter. Among those 50 diagnosed upon subsequent screens, 28 (56%) were identified in association with positive screens, suggesting that 22% (28 of 127) of TB diagnoses could be attributed to the serial screening protocol. Conclusion: Provider-initiated serial clinical screening during routine visits of HIV-infected outpatients continued to prompt treatment of active TB beyond initial screening. Serial screening strategies may lead to earlier TB treatment in patients receiving ongoing HIV care in resource-limited settings.
Authors and Affiliations
Ellie R. Carmody, Aabid Ahmed, Robert S. Holzman, Farhad Abdulaziz, Musa Mwamzuka, Maura Laverty, Sumathi Sivapalasingam
Keywords
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- EP ID EP348869
- DOI 10.9734/BJMMR/2014/6647
- Views 66
- Downloads 0
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