Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #108857

Ashraf A. Mohammed, Mr, HIV/AIDS Programme Unit, Cape Peninsula University of Technology, PO Box 652, Cape Town, South Africa, 027 021 4604252/3, mohammedaa@cput.ac.za

Introduction: HIV is regarded as the most potent activator of tuberculosis. Active tuberculosis screening is important in these patients prior to initiating tuberculosis preventive therapy in order to prevent development of drug resistance. But detecting tuberculosis among patients with symptomatic human immunodeficiency virus (HIV) disease is difficult. Aim: To review the innovative Tuberculosis screening instrument for that is capable of detecting Tuberculosis with advanced HIV based on constitutional symptoms of Tuberculosis in high Tuberculosis prevalence areas.Objective: To calculate the test validity of various symptoms, signs and laboratory investigations for active Tuberculosis in this settingMethod: Patients with clinically advanced HIV disease were screened for active tuberculosis using a symptom questionnaire, measured weight loss, chest radiography, sputum microscopy and culture prior to receiving tuberculosis preventive therapy. In addition a Mantoux test was conducted on all patients screened.Results: Tuberculosis was diagnosed in 11 of 129 patients screened. Simple screening instrument of two or more of the symptoms measured weight loss, cough, night sweats or fever, had a sensitivity of 100% and specificity of 88.1%, and positive and negative predictive values of 44% and 100%, respectively.Conclusions: We found 8.5% of active tuberculosis among adults with clinically advanced HIV. We have demonstrated that a simple screening instrument of symptoms and documented weight loss can effectively exclude Tuberculosis in adult patients with advanced HIV.Recommendations: Active tuberculosis case finding should be an integral component of HIV management at a primary care and voluntary counseling and testing centers.

Learning Objectives:

• To review the innovative Tuberculosis screening instrument for that is capable of detecting Tuberculosis with advanced HIV based on constitutional symptoms of Tuberculosis in high Tuberculosis prevalence areas
• To calculate the test validity of various symptoms, signs and laboratory investigations for active Tuberculosis in this setting

Keywords: Screening Instruments, Tuberculosis

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.