Loss to follow-up is the major operational issue relevant to scale-up of screen-and-treat. Patient outcomes may be improved by rapid access to CrAg results and focus on linkage to and retention in HIV care.

Bartonellae are highly adaptive organisms that have the ability to evade the host immune system and cause persistent bacteraemia by occupying the host's erythrocytes. Bartonella spp. is under-studied and health care professionals often misdiagnose Bartonella-related infections. The aim of this study was to investigate the carriage of Bartonella spp. circulating in human and animal populations in Gauteng using culturing and polymerase chain reaction (PCR) detection. A total of 424 human, 98 cat, 179 dog, and 124 wild rodent blood samples were plated onto specialised media and incubated for 7-21 days at 37 ºC in CO2. Culture isolates morphologically similar to Bartonella control strains were confirmed by PCR and sequenced to determine species. Deoxyribonucleic acid (DNA) was extracted from all blood samples and tested by nested PCR. Bartonella could only be cultured from the cat and rodent specimens. Cat isolates were > 99% similar to Bartonella henselae URBHLIE 9, previously isolated from an endocarditis patient, and rat isolates were > 98% similar to either RN24BJ (candidus 'Bartonella thailandensis') or RN28BJ, previously isolated from rodents in China. The PCR prevalences were 22.5% in HIV-positive patients, 9.5% in clinically healthy volunteers, 23.5% in cats, 9% in dogs and 25% in rodents. Findings of this study have important implications for HIV-positive patients.

The impact of tuberculosis (TB) on older adults in Southern Africa is rarely emphasised. The case notification rate in 2004 among the elderly in Soweto was 262 per 100 000 population. The elderly comprised 5.8% of adults and 1.6% of adults notified. Among 110 elderly patients studied, 50% had pulmonary TB, 37% had extra-pulmonary TB (EPTB) and 13% had both. A predisposing disease occurred in 46%. TB was microbiologically proven in 77%. Human immunodeficiency virus (HIV) status was known for 25 (23%) patients, with 10 (9% of the cohort) being HIV-infected. HIV-infected adults had more EPTB, anaemia and hyponatraemia. Older adults in Soweto bear a high burden of TB.