Free Content Missed opportunities for diagnosis of tuberculosis and human immunodeficiency virus co-infection in Moshi, Tanzania

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Abstract:

SETTING: A community-based voluntary counseling and testing (VCT) center in Moshi, Tanzania.

OBJECTIVE: To compare rates of prior human immunodeficiency virus (HIV) testing among clients with and without previous tuberculosis (TB) treatment, and HIV seropositivity among those with and without current TB symptoms.

DESIGN: Cross-sectional study of consecutive clients presenting for initial testing; sociodemographic and clinical data were collected via a structured questionnaire. HIV status was compared among clients with or without three or more TB-related symptoms: weight loss, fever, cough, hemoptysis or night sweats.

RESULTS: Overall, 225 (3%) of 6583 VCT clients who responded to questions on previous TB treatment reported a history of TB, but only 34 (15%) reported previous HIV testing. This rate of HIV testing was not different from the rate among those clients without a history of TB (OR 0.77, P = 0.175). One hundred thirty-five (61%) clients with a history of TB were HIV-infected at VCT, compared with 17% of all clients. Of the total 6592 first-time testers who responded, 372 (6%) had at least three symptoms suggestive of TB at VCT. These symptoms were strongly associated with HIV seropositivity (OR 16.30, P < 0.001).

CONCLUSION: Missed opportunities for HIV diagnosis at the time of TB treatment appear frequent in this population, underscoring the need for integration of TB and HIV diagnostic services.

Keywords: HIV; Tanzania; tuberculosis; voluntary counseling and testing

Document Type: Regular Paper

Affiliations: 1: Duke University Medical Center, Durham, North Carolina, USA 2: Duke University Medical Center, Durham, North Carolina, USA; Kilimanjaro Christian Medical Centre, Moshi, Tanzania; and Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania 3: Kikundi cha Wanawake Kilimanjaro Kupambana na UKIMWI (Women Against AIDS in Kilimanjaro), Moshi, Tanzania 4: Kilimanjaro Christian Medical Centre, Moshi, Tanzania 5: Kilimanjaro Christian Medical Centre, Moshi, Tanzania; and Kilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania

Publication date: October 1, 2009

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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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