Implementation and Operational Research: Population-Based Active Tuberculosis Case Finding During Large-Scale Mobile HIV Testing Campaigns in Rural Uganda. (1st November 2016)

• Record Type: Journal Article
• Authors: Ssemmondo, Emmanuel; Mwangwa, Florence; Kironde, Joel L.; Kwarisiima, Dalsone; Clark, Tamara D.; Marquez, Carina; Charlebois, Edwin D.; Petersen, Maya L.; Kamya, Moses R.; Havlir, Diane V.; Chamie, Gabriel
• Is Part Of: Journal of acquired immune deficiency syndromes. Volume 73:Number 3(2017)
• Publication Date: 2016-11-01
• Subjects: active TB case finding -- HIV -- community health campaigns; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome -- Periodicals; AIDS (Disease); Periodicals; 616.9792005
• DOI: 10.1097/QAI.0000000000001142
• Languages: English
• ISSNs: 1525-4135

Abstract

Abstract : Background: Active tuberculosis (TB) screening outside clinics and in communities may reduce undiagnosed TB. Methods: To determine the yield of TB screening during community-based HIV testing campaigns (CHC) in 7 rural Ugandan communities within an ongoing cluster-randomized trial of universal HIV testing and treatment (SEARCH, NCT:01864603), we offered sputum microscopy to participants with prolonged cough (>2 weeks). We determined the number of persons needed to screen to identify one TB case, and the number of cases identified that linked to clinic and completed TB treatment. Results: Of 36, 785 adults enumerated in 7 communities, 27, 214 (74%) attended CHCs, and HIV testing uptake was >99%, with 941 (3.5%) HIV-infected adults identified. Five thousand seven hundred eighty-six adults (21%) reported cough and 2876 (11%) reported cough >2 weeks. Staff obtained sputum in 1099/2876 (38%) participants with prolonged cough and identified 10 adults with AFB-positive sputum; 9 new diagnoses and 1 known case already under treatment. The number needed to screen to identify one new TB case was 3024 adults overall: 320 adults with prolonged cough and 80 HIV-infected adults with prolonged cough. All 9 newly diagnosed AFB+ participants were linked to TB care within 2 weeks and were initiated TB treatment. Conclusions: In a rural Ugandan setting, TB screening as an adjunct to large-scale mobile HIV testing campaigns provides an opportunity to increase TB case detection.