SETTING: The Groupe Haïtien d'étude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) Centres, Port-au-Prince, Haiti, facilitate “test and treat” strategies by screening all patients for tuberculosis (TB) at human immunodeficiency virus (HIV) testing.OBJECTIVE: 1) To determine the proportion of patients with chronic cough at HIV testing diagnosed with TB, stratified by HIV test results; and 2) to evaluate the additional diagnostic yield of Xpert® MTB/RIF vs. sputum microscopy.DESIGN: We conducted a retrospective cohort analysis including all adults tested for HIV at GHESKIO from August 2014 to July 2015.RESULTS: Of 29 233 adult patients tested for HIV, 2953 (10%) were diagnosed as HIV-positive. Chronic cough lasting ≥2 weeks was reported by 1116 (38%) HIV-positive patients; 984 (88%) were tested and 265 (27%) were diagnosed with TB. Chronic cough was reported by 5985 (23%) HIV-negative patients; 5654 (94%) were tested and 1179 (21%) were diagnosed with TB. Of all bacteriologically confirmed cases, 27% were smear-negative and Xpert-positive. Among all TB patients, 81% were HIV-negative.CONCLUSIONS: Screening for TB at HIV testing was high-yield, among both HIV-infected and HIV-negative individuals. Testing for both diseases should be conducted among patients who present with chronic cough at HIV testing.

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Background: Nontuberculous mycobacterial (NTM) infections are becoming more common, but the epidemiologic characteristics of NTM in much of the world remain largely unknown. The purpose of this study was to evaluate the prevalence and risk factors for NTM infection in a southern coastal area of China.Results: 1759 individuals suspected of having tuberculosis were included in the analysis, of whom 140 (7.96%) had NTM isolated from their sputa. The NTM species identified by the Kraken 2/Bracken and Hain methods were highly consistent. M. abscessus complex bacilli were the most prevalent species isolated (n=58, 41.43%), followed by the Mycobacterium avium complex (MAC) (n=41, 29.29%). Residency in Shenzhen for more than 2 years (OR 4.205; 95% CI 1.851-9.552; P = 0.001) and a history of prior TB (OR 4.263; 95% CI 1.871-9.714; P = 0.001) increased the risk for NTM infections. Whole-genome sequencing data from many of the MAC isolates showed high genomic diversity and heterogeneity.Conclusion: M. abscessus was the most common causative NTM species found in symptomatic patients in this region. Living in Shenzhen for more than 2 years and having a previous history of TB were associated with an increased risk of NTM infection. MAC genomes are often heterogenous.