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DC Field | Value | Language |
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dc.contributor.author | Fenner, Lukas | - |
dc.contributor.author | Ballif, Marie | - |
dc.contributor.author | Graber, Claire | - |
dc.contributor.author | Nhandu, Venerandah | - |
dc.contributor.author | Cortes, Claudia P. | - |
dc.contributor.author | Gnokoro, Joachim Charles | - |
dc.contributor.author | Garone, Daniela | - |
dc.contributor.author | Wools-Kaloustian, Kara | - |
dc.contributor.author | Diero, Lameck | - |
dc.contributor.author | Sued, Omar | - |
dc.contributor.author | Ajayi, Samuel | - |
dc.date.accessioned | 2020-07-28T07:12:07Z | - |
dc.date.available | 2020-07-28T07:12:07Z | - |
dc.date.issued | 2013 | - |
dc.identifier.uri | https://doi.org/10.1371/journal.pone.0077697 | - |
dc.identifier.uri | http://ir.mu.ac.ke:8080/jspui/handle/123456789/3134 | - |
dc.description.abstract | Objectives In resource-constrained settings, tuberculosis (TB) is a common opportunistic infection and cause of death in HIV-infected persons. TB may be present at the start of antiretroviral therapy (ART), but it is often under-diagnosed. We describe approaches to TB diagnosis and screening of TB in ART programs in low- and middle-income countries. Methods and findings We surveyed ART programs treating HIV-infected adults in sub-Saharan Africa, Asia and Latin America in 2012 using online questionnaires to collect program-level and patient-level data. Forty-seven sites from 26 countries participated. Patient-level data were collected on 987 adult TB patients from 40 sites (median age 34.7 years; 54% female). Sputum smear microscopy and chest radiograph were available in 47 (100%) sites, TB culture in 44 (94%), and Xpert MTB/RIF in 23 (49%). Xpert MTB/RIF was rarely available in Central Africa and South America. In sites with access to these diagnostics, microscopy was used in 745 (76%) patients diagnosed with TB, culture in 220 (24%), and chest X-ray in 688 (70%) patients. When free of charge culture was done in 27% of patients, compared to 21% when there was a fee (p = 0.033). Corresponding percentages for Xpert MTB/RIF were 26% and 15% of patients (p = 0.001). Screening practices for active disease before starting ART included symptom screening (46 sites, 98%), chest X-ray (38, 81%), sputum microscopy (37, 79%), culture (16, 34%), and Xpert MTB/RIF (5, 11%). Conclusions Mycobacterial culture was infrequently used despite its availability at most sites, while Xpert MTB/RIF was not generally available. Use of available diagnostics was higher when offered free of charge. | en_US |
dc.language.iso | en | en_US |
dc.publisher | Plos | en_US |
dc.subject | Antiretroviral treatment | en_US |
dc.subject | Tuberculosis | en_US |
dc.subject | Sputum | en_US |
dc.title | Tuberculosis in antiretroviral treatment programs in lower income countries: availability and use of diagnostics and screening | en_US |
dc.type | Article | en_US |
Appears in Collections: | School of Medicine |
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