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Free Content Prevalence of the human immunodeficiency virus among patients with tuberculosis in Sierra Leone, established from dried blood spots on filter paper

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SETTING: Sierra Leone National Tuberculosis Programme.

OBJECTIVE: To evaluate serological testing in field conditions of dried blood spots (DBS) on filter paper for unlinked surveillance of human immunodeficiency virus (HIV) associated tuberculosis.

DESIGN: DBS were first evaluated against sera in 359 consenting patients on the capital city's District Tuberculosis Register (DTR). DBS eluates were tested with repeated ELISA using different antigens. Serum samples were tested with ELISA and confirmed with LIA. The cost was compared with that of rapid/simple tests on whole blood. In a second phase, DBS were applied to an unlinked countrywide serosurvey of 582 patients from the DTRs.

RESULTS: The specificity of DBS for HIV-1 and HIV-2 was 100% and sensitivity was 100% and 87.5%, respectively. The cost of the strategy was half that of rapid/simple tests on whole blood. In 1995, HIV-1 associated tuberculosis seroprevalence was 2.41%.

CONCLUSION: The proposed method for the surveillance of HIV-1 associated tuberculosis in Africa is simple, cheap and accurate. Further investigations are necessary to evaluate its sensitivity for HIV-2, and to study the epidemiology of HIV-2 in Sierra Leone.
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Keywords: HIV; Sierra Leone; filter paper; surveillance; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Formerly National Leprosy and Tuberculosis Control Programme, Freetown, Sierra Leone, currently Unité Santé UE, Port au Prince, Haiti 2: Laboratoire des Retrovirus, Centre ORSTOM, France 3: National AIDS Control Programme, Freetown, Sierra Leone

Publication date: 01 December 1997

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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