Abstract:
Objective: To determine the diagnostic usefulness of tu-
berculosis (TB) symptom screening to detect active pul-
monary TB among human immunodeficiency virus (HIV)
infected pregnant women in two PMTCT (prevention of
mother-to-child transmission) clinics in western Kenya
that are supported by the United States Agency for Inter-
national Development–Academic Model Providing Access
to Healthcare partnership.
Design: Cross-sectional study. Participants were inter-
viewed for TB symptoms with a standardized question-
naire (cough >2 weeks, fever, night sweats, weight loss or
failure to gain weight). Those with cough submitted spu-
tum specimens for smear microscopy for acid-fast bacilli
and mycobacterial culture. Women at >14 weeks gesta-
tion underwent shielded chest radiography (CXR).
Results: Of 187 HIV-infected women, 38 (20%) were
symptom screen-positive. Of these, 21 had a cough for
>2 weeks, but all had negative sputum smears and my-
cobacterial cultures. CXRs were performed in 26 symp-
tomatic women: three were suggestive of TB (1 miliary,
1 infiltrates and 1 cavitary). Of 149 women with a nega-
tive symptom screen, 100 had a CXR and seven had a CXR
suggestive of TB (1 cavitary, 2 miliary and 4 infiltrates).
Conclusion: This study did not support the utility of iso-
lated symptom screening in identification of TB disease in
our PMTCT setting. CXR was useful in identification of TB
suspects in both symptomatic and asymptomatic women
