Short Course for Focused Assessment with Sonography for Human Immunodeficiency Virus/Tuberculosis: Preliminary Results in a Rural Setting in South Africa with High Prevalence of Human Immunodeficiency Virus and Tuberculosis

Abstract

In Africa, human immunodeficiency virus (HIV)–associated extrapulmonary tuberculosis (TB) is common and poses diagnostic difficulties. Ultrasound is useful to find suggestive signs such as effusions or abdominal lymphadenopathy. Because trained radiologists are scarce in resource-poor settings, even this simple and relatively inexpensive diagnostic tool is frequently unavailable to patients in district hospitals in sub-Saharan Africa. We developed a focused protocol for assessment with sonography for HIV/TB and trained physicians in a rural district hospital in South Africa. In this pilot study, high levels of confidence in identifying specific signs were rapidly achieved and ultrasound was introduced into routine clinical practice.

Ultrasound findings in cases of extrapulmonary TB in patients with HIV infection in Jeddah, Saudi Arabia

“…In 13 patients (9 additional patients) lesions were diagnostically biopsied which confirmed the EPTB diagnosis. The remaining 13 patients were considered as possible TB diagnosis as they had typical signs and symptoms which improved with TB treatment [4] .…”

“…In the appropriate clinical setting, US imaging results were found to be specific enough to make empiric treatment of TB [3] and consequently of HIV infection warranted. Abbreviated US protocols similar to point-ofcare US used in emergency medicine departments were developed to widen access to US in resource-poor settings [4] . The findings suggestive of EPTB include pericardial effusion, pleural effusion and in some patients ascites.…”

Usefulness of ultrasound in the diagnosis of peritoneal tuberculosis

“…Despite these benefits, the use of ultrasound in rural, limitedresource settings has not reached its full potential because of the lack of equipment and trained personnel. The World Health Organization scientific Group on Clinical Diagnostic Imaging has noted that the need for trained personnel is greater than the need for equipment [14], and for that reason, short training courses on ultrasound for physicians or other health care workers, focused on limited key findings, may be an option to provide this technical knowledge in countries where diagnostic methods are limited [15].…”

Point-of-Care Ultrasound Assessment of Tropical Infectious Diseases—A Review of Applications and Perspectives

“…25 It has also been documented extensively in EM that pleural, 26 pericardial, 27 and ascitic 4 fluid can be detected by POCUS with high sensitivity and specificity. There is no reason to doubt the similar value of POCUS for the detection of effusions and ascites secondary to infectious diseases.…”