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Free Content Using tuberculosis suspects to identify patients eligible for antiretroviral treatment

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SETTING: A district in rural sub-Saharan Africa with a recently introduced antiretroviral (ARV) programme. The population has high human immunodeficiency virus (HIV) prevalence and high tuberculosis (TB) incidence.

OBJECTIVE: To determine the prevalence of HIV and acquired immune-deficiency syndrome (AIDS) related symptoms in people presenting with chronic cough who are not diagnosed with TB.

DESIGN: A cross-sectional survey of TB suspects.

METHODS: Patients with chronic cough were recruited from out-patient facilities. After standard diagnostic procedures and providing informed consent, they received counselling and testing for HIV, and were interviewed and examined with respect to staging criteria for HIV/AIDS. Suspects were followed up for 3 months after the end of the recruitment period to allow for delayed diagnosis of TB.

RESULTS: Of 145 suspects, 79% had not been diagnosed with TB by the end of the follow-up period. Of these, 108 (95%) agreed to HIV testing and 61 (56%) were HIV-positive. More than half of these were eligible for ARV treatment (Stage III or IV disease) under national programme criteria.

CONCLUSION: Established chronic cough clinics are a useful setting for recruitment of patients to ARV clinics. Attendees should be offered HIV testing and simple clinical screening to identify those who should be referred for ARV treatment.
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Keywords: AIDS; Malawi; antiretroviral treatment; diagnosis; tuberculosis

Document Type: Regular Paper

Affiliations: 1: College of Medicine, Blantyre, Malawi 2: Karonga Prevention Study, Karonga, Malawi 3: Karonga Prevention Study, Karonga, Malawi; and London School of Hygiene and Tropical Medicine, London, United Kingdom

Publication date: 01 February 2006

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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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