Improving the diagnosis of pulmonary tuberculosis in HIV-infected individuals in Ho Chi Minh City, Viet Nam.
| Autor: | Nguyen DT; University of Texas School of Public Health, Houston, Texas 77030, USA. ntmduc@yahoo.com, Hung NQ, Giang LT, Dung NH, Lan NT, Lan NN, Yen NT, Bang ND, Ngoc DV, Trinh LT, Beasley RP, Ford CE, Hwang LY, Graviss EA |
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| Jazyk: | angličtina |
| Zdroj: | The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease [Int J Tuberc Lung Dis] 2011 Nov; Vol. 15 (11), pp. 1528-34, i. |
| DOI: | 10.5588/ijtld.10.0777 |
| Abstrakt: | Setting: District 6, An Hoa Clinic in Ho Chi Minh City (HCMC), Viet Nam. Objective: To evaluate the performance of various algorithms in tuberculosis (TB) screening and diagnosis in a human immunodeficiency virus (HIV) infected population in HCMC, Viet Nam. Design: A cross-sectional study of 397 consecutive HIV-infected patients seeking care at the An Hoa Clinic from August 2009 to June 2010. Data on participant demographics, clinical status, chest radiography (CXR) and laboratory results were collected. A multiple logistic regression model was developed to assess the association of covariates and pulmonary TB (PTB). Results: The prevalence of sputum culture-confirmed PTB, acid-fast bacilli (AFB) positive TB, and multidrugresistant TB among the 397 HIV-infected patients was respectively 7%, 2%, and 0.3%. Adjusted odds ratios for low CD4+ cell count, positive sputum smear, and CXR to positive sputum culture were respectively 3.17, 32.04 and 4.28. Clinical findings alone had poor sensitivity, but combining CD4+ cell count, AFB sputum smear and CXR had a more accurate diagnostic performance. Conclusion: Results suggest that symptom screening had poor clinical performance, and support the routine use of sputum culture to improve the detection of TB disease in HIV-infected individuals in Viet Nam. However, when routine sputum culture is not available, an algorithm combining CD4+ cell count, AFB sputum smear and CXR is recommended for diagnosing PTB. |
| Databáze: | MEDLINE |
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