Characteristics of sputum smear-positive tuberculosis patients with and without HIV infection in a hospital in Zimbabwe

Schoch, Otto D.; Rieder, H. L.

doi:10.1183/09031936.96.09020284

Cited by 10 publications

(6 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients presented with clinical symptoms that have been described before [31][32][33][34]. However, patients with HIV-TB coinfection were more symptomatic and presented with features suggestive of TB, despite similar low CD4 + T-cell counts as the HIV-only patients.…”

Section: Discussionmentioning

confidence: 88%

“…This study describes the risk factors for mortality and clinical characteristics of HAART-naive patients initiated on treatment with the CD4 + T-cell count ≤200 cells/ ml. Patients presented with clinical symptoms that have been described before [31][32][33][34]. However, patients with HIV-TB coinfection were more symptomatic and presented with features suggestive of TB, despite similar low CD4 + T-cell counts as the HIV-only patients.…”

Section: Discussionmentioning

confidence: 88%

See 1 more Smart Citation

Risk Factors for Mortality among HIV-Positive Patients with and without Active Tuberculosis in Dar Es Salaam, Tanzania

et al. 2012

View full text Add to dashboard Cite

Background: The aim of this study was to describe risk factors for mortality and clinical characteristics of HIVinfected patients with and without tuberculosis (TB) coinfection. Methods: A cohort of HIV-infected patients with CD4 + T-cell counts of ≤200 cells/ml was recruited, consisting of 255 HIV-infected patients without active TB and 231 patients with active TB. All received a well-supervised treatment with an efavirenz-based HAART, and those coinfected with TB received appropriate anti-TB treatment. They were followed up for 48 weeks after HAART initiation. Results: Common presenting symptoms in HIV-only patients were fever (36.5%), headache (34.5%), skin rash (34.5%) and weight loss (32%), while in HIV-TB patients the symptoms were weight loss (58%), cough (57.6%), night sweats (44.6%) and fever (34.2%). HIV-TB patients had significantly lower body mass index, Karnofsky scores and haemoglobin levels compared to those infected with HIV only, despite similar baseline CD4 + T-cell counts. Overall, 12 (4.7%) HIV patients developed TB and 7 (3%) HIV-TB patients had worsening of their TB symptoms during the study period. Mortality was similar in the two groups, being 10.9% (16 deaths per 100 person years) and 11.3% (17 deaths per 100 person years) in HIV-only and HIV-TB patients, respectively. Overall, more males (13.1%) died compared to females (9.6%). Predictors of mortality were presence of oral candidiasis, Kaposi's sarcoma, low Karnofsky score, and low baseline white blood cell and CD4 + T-cell counts. Conclusions: The outcomes following well-supervised treatment of HIV-TB patients are similar to those in patients with HIV alone. Predictors of mortality were those of advanced disease.

show abstract

Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 88%

Risk Factors for Mortality among HIV-Positive Patients with and without Active Tuberculosis in Dar Es Salaam, Tanzania

et al. 2012

View full text Add to dashboard Cite

show abstract

“…The proportion of sputum smear positive TB cases among all forms of TB varies in different reports and may be related to the population studied, the setting, the sensitivity of the diagnostic method and microscopy quality assurance issues [ 29 – 35 ]. Consequently the diverse circumstances and populations studied contribute to the range of 31.6% to 77% found in studies from different parts of the world [ 29 – 35 ]. The proportion of SS+ve TB among the various categories of patients in our study fell within this range.…”

Section: Discussionmentioning

confidence: 99%

Provider initiated tuberculosis case finding in outpatient departments of health care facilities in Ghana: yield by screening strategy and target group

Ohene

Bonsu²,

Hanson-Nortey³

et al. 2017

BMC Infect Dis

View full text Add to dashboard Cite

BackgroundMeticulous identification and investigation of patients presenting with tuberculosis (TB) suggestive symptoms rarely happen in crowded outpatient departments (OPDs). Making health providers in OPDs diligently follow screening procedures may help increase TB case detection. From July 2010 to December 2013, two symptom based TB screening approaches of varying cough duration were used to screen and test for TB among general outpatients, PLHIV, diabetics and contacts in Accra, Ghana.MethodsThis study was a retrospective analysis comparing the yield of TB cases using two different screening approaches, allocated to selected public health facilities. In the first approach, the conventional 2 weeks cough duration with or without other TB suggestive symptoms was the criterion to test for TB in attendants of 7 general OPDs. In the second approach the screening criteria cough of >24 hours, as well as a history of at least one of the following symptoms: fever, weight loss and drenching night sweats were used to screen and test for TB among attendants of 3 general OPDs, 7 HIV clinics and 2 diabetes clinics. Contact investigation was initiated for index TB patients. The facilities documented the number of patients verbally screened, with presumptive TB, tested using smear microscopy and those diagnosed with TB in order to calculate the yield and number needed to screen (NNS) to find one TB case. Case notification trends in Accra were compared to those of a control area.ResultsIn the approach using >24-hour cough, significantly more presumptive TB cases were identified among outpatients (0.82% versus 0.63%), more were tested (90.1% versus 86.7%), but less smear positive patients were identified among those tested (8.0% versus 9.4%). Overall, all forms of TB cases identified per 100,000 screened were significantly higher in the >24-hour cough approach at OPD (92.7 for cough >24 hour versus 82.7 for cough >2 weeks ), and even higher in diabetics (364), among contacts (693) and PLHIV (995). NNS (95% Confidence Interval) varied from 100 (93-109) for PLHIV, 144 (112-202) for contacts, 275 (197-451) for diabetics and 1144 (1101-1190) for OPD attendants. About 80% of the TB cases were detected in general OPDs. Despite the intervention, notifications trends were similar in the intervention and control areas.ConclusionThe >24-hour cough approach yielded more TB cases though required TB testing for a larger number of patients. The yield of TB cases per 100,000 population screened was highest among PLHIV, contacts, and diabetics, but the majority of cases were detected in general OPDs. The intervention had no discernible impact on general case notification.

show abstract

“…In the United States, foreign-born persons comprise an increasing proportion of cases [1,5] and HIV commonly coinfects persons with tuberculosis, potentially altering disease presentation [6][7][8].…”

mentioning

confidence: 99%

A Population-Based Survey of Tuberculosis Symptoms: How Atypical Are Atypical Presentations?

Miller

Asch

et al. 2000

Clinical Infectious Diseases

View full text Add to dashboard Cite

There is scant information on tuberculosis symptoms from a population-based perspective. We prospectively identified 526 tuberculosis cases reported in Los Angeles County over a 6-month period. Of 313 persons who completed our questionnaire, 72.7% had cough, 48.2% for >2 weeks, and 52.3% had fever, 29.4% for >2 weeks. Among those with pulmonary disease, only 52.4% had cough for >2 weeks. In a multivariate model, persons with significant symptoms typical of tuberculosis disease (defined as cough or fever for >2 weeks, weight loss, or hemoptysis) were associated with lack of medical insurance, negative tuberculin skin test, diagnosis during a process other than screening, and non-Asian race. In summary, classic symptoms of prolonged cough and fever are insensitive predictors of tuberculosis. Our data suggest that Asians may need to be added to the list of persons who present with tuberculosis atypically. We believe that the Infectious Diseases Society of America guidelines for community-acquired pneumonia should emphasize demographic features in addition to clinical symptoms when suggesting which patients require evaluation for Mycobacterium tuberculosis.

show abstract

Characteristics of sputum smear-positive tuberculosis patients with and without HIV infection in a hospital in Zimbabwe

Cited by 10 publications

References 12 publications

Risk Factors for Mortality among HIV-Positive Patients with and without Active Tuberculosis in Dar Es Salaam, Tanzania

Risk Factors for Mortality among HIV-Positive Patients with and without Active Tuberculosis in Dar Es Salaam, Tanzania

Provider initiated tuberculosis case finding in outpatient departments of health care facilities in Ghana: yield by screening strategy and target group

A Population-Based Survey of Tuberculosis Symptoms: How Atypical Are Atypical Presentations?

Contact Info

Product

Resources

About