HIV-TB: epidemiology, clinical features and diagnosis of smear-negativeTB

Keshinro, Babajide; Diul, Mukadi Ya

doi:10.1258/004947506776593396

Cited by 18 publications

(9 citation statements)

References 9 publications

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“…On the other hand, physicians more frequently identified HIV/AIDS as a cause of death than the model. This is not entirely surprising as there is a great deal of overlap between both disease conditions in terms of clinical symptoms and signs [36]. Furthermore, the re-emergence of pulmonary tuberculosis in several countries of the world is spurred by the HIV/AIDS pandemic [37].…”

Section: Discussionmentioning

confidence: 99%

Verbal autopsy interpretation: a comparative analysis of the InterVA model versus physician review in determining causes of death in the Nairobi DSS

Oti

Kyobutungi

2010

Popul Health Metrics

101

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BackgroundDeveloping countries generally lack complete vital registration systems that can produce cause of death information for health planning in their populations. As an alternative, verbal autopsy (VA) - the process of interviewing family members or caregivers on the circumstances leading to death - is often used by Demographic Surveillance Systems to generate cause of death data. Physician review (PR) is the most common method of interpreting VA, but this method is a time- and resource-intensive process and is liable to produce inconsistent results. The aim of this paper is to explore how a computer-based probabilistic model, InterVA, performs in comparison with PR in interpreting VA data in the Nairobi Urban Health and Demographic Surveillance System (NUHDSS).MethodsBetween August 2002 and December 2008, a total of 1,823 VA interviews were reviewed by physicians in the NUHDSS. Data on these interviews were entered into the InterVA model for interpretation. Cause-specific mortality fractions were then derived from the cause of death data generated by the physicians and by the model. We then estimated the level of agreement between both methods using Kappa statistics.ResultsThe level of agreement between individual causes of death assigned by both methods was only 35% (κ = 0.27, 95% CI: 0.25 - 0.30). However, the patterns of mortality as determined by both methods showed a high burden of infectious diseases, including HIV/AIDS, tuberculosis, and pneumonia, in the study population. These mortality patterns are consistent with existing knowledge on the burden of disease in underdeveloped communities in Africa.ConclusionsThe InterVA model showed promising results as a community-level tool for generating cause of death data from VAs. We recommend further refinement to the model, its adaptation to suit local contexts, and its continued validation with more extensive data from different settings.

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Section: Discussionmentioning

confidence: 99%

Verbal autopsy interpretation: a comparative analysis of the InterVA model versus physician review in determining causes of death in the Nairobi DSS

Oti

Kyobutungi

2010

Popul Health Metrics

101

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“…Additionally, this strategy could reduce the risk of dissemination and spread to other hospitalized patients and health care personnel [2,26]. …”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of PCR for the rapid diagnosis of pulmonary tuberculosis

et al. 2009

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BackgroundTuberculosis is one of the most prominent health problems in the world, causing 1.75 million deaths each year. Rapid clinical diagnosis is important in patients who have co-morbidities such as Human Immunodeficiency Virus (HIV) infection. Direct microscopy has low sensitivity and culture takes 3 to 6 weeks [1-3]. Therefore, new tools for TB diagnosis are necessary, especially in health settings with a high prevalence of HIV/TB co-infection.MethodsIn a public reference TB/HIV hospital in Brazil, we compared the cost-effectiveness of diagnostic strategies for diagnosis of pulmonary TB: Acid fast bacilli smear microscopy by Ziehl-Neelsen staining (AFB smear) plus culture and AFB smear plus colorimetric test (PCR dot-blot).From May 2003 to May 2004, sputum was collected consecutively from PTB suspects attending the Parthenon Reference Hospital. Sputum samples were examined by AFB smear, culture, and PCR dot-blot. The gold standard was a positive culture combined with the definition of clinical PTB. Cost analysis included health services and patient costs.ResultsThe AFB smear plus PCR dot-blot require the lowest laboratory investment for equipment (US$ 20,000). The total screening costs are 3.8 times for AFB smear plus culture versus for AFB smear plus PCR dot blot costs (US$ 5,635,760 versus US$ 1,498, 660). Costs per correctly diagnosed case were US$ 50,773 and US$ 13,749 for AFB smear plus culture and AFB smear plus PCR dot-blot, respectively. AFB smear plus PCR dot-blot was more cost-effective than AFB smear plus culture, when the cost of treating all correctly diagnosed cases was considered. The cost of returning patients, which are not treated due to a negative result, to the health service, was higher in AFB smear plus culture than for AFB smear plus PCR dot-blot, US$ 374,778,045 and US$ 110,849,055, respectively.ConclusionAFB smear associated with PCR dot-blot associated has the potential to be a cost-effective tool in the fight against PTB for patients attended in the TB/HIV reference hospital.

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“…[56]. Though, several Th-1 skewed immune functions were severely compromised in full blown AIDS, but their dysfunctions often appear in asymptomatic cases as well [52,57].…”

Section: Chronology Of Immunopathogenesis In Hiv-tbmentioning

confidence: 99%

HIV induced suppression of host immunity: relevance to <i>Mycobacterium tuberculosis</i> infections

Kumar¹,

Mitra²

2017

HIV & AIDS Review

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HIV-TB: epidemiology, clinical features and diagnosis of smear-negativeTB

Cited by 18 publications

References 9 publications

Verbal autopsy interpretation: a comparative analysis of the InterVA model versus physician review in determining causes of death in the Nairobi DSS

Verbal autopsy interpretation: a comparative analysis of the InterVA model versus physician review in determining causes of death in the Nairobi DSS

Cost-effectiveness analysis of PCR for the rapid diagnosis of pulmonary tuberculosis

HIV induced suppression of host immunity: relevance to <i>Mycobacterium tuberculosis</i> infections

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