دورية أكاديمية
أعرض في EDS

Tuberculosis in antiretroviral treatment programs in lower income countries: availability and use of diagnostics and screening.

التفاصيل البيبلوغرافية
العنوان: Tuberculosis in antiretroviral treatment programs in lower income countries: availability and use of diagnostics and screening.
المؤلفون: Fenner L; Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland ; Swiss Tropical and Public Health Institute, Basel, Switzerland ; University of Basel, Basel, Switzerland., Ballif M, Graber C, Nhandu V, Dusingize JC, Cortes CP, Carriquiry G, Anastos K, Garone D, Jong E, Gnokoro JC, Sued O, Ajayi S, Diero L, Wools-Kaloustian K, Kiertiburanakul S, Castelnuovo B, Lewden C, Durier N, Sterling TR, Egger M
مؤلفون مشاركون: International epidemiological Databases to Evaluate AIDS (IeDEA)
المصدر: PloS one [PLoS One] 2013 Oct 17; Vol. 8 (10), pp. e77697. Date of Electronic Publication: 2013 Oct 17 (Print Publication: 2013).
نوع المنشور: Journal Article; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE
أسماء مطبوعة: Original Publication: San Francisco, CA : Public Library of Science
مواضيع طبية MeSH: Tuberculosis/*diagnosis , Tuberculosis/*drug therapy, Adult ; Africa South of the Sahara/epidemiology ; Anti-Retroviral Agents/therapeutic use ; Asia/epidemiology ; Female ; Geography ; Humans ; Latin America/epidemiology ; Male ; Surveys and Questionnaires ; Tuberculosis/epidemiology
مستخلص: Objectives: In resource-constrained settings, tuberculosis (TB) is a common opportunistic infection and cause of death in HIV-infected persons. TB may be present at the start of antiretroviral therapy (ART), but it is often under-diagnosed. We describe approaches to TB diagnosis and screening of TB in ART programs in low- and middle-income countries.
Methods and Findings: We surveyed ART programs treating HIV-infected adults in sub-Saharan Africa, Asia and Latin America in 2012 using online questionnaires to collect program-level and patient-level data. Forty-seven sites from 26 countries participated. Patient-level data were collected on 987 adult TB patients from 40 sites (median age 34.7 years; 54% female). Sputum smear microscopy and chest radiograph were available in 47 (100%) sites, TB culture in 44 (94%), and Xpert MTB/RIF in 23 (49%). Xpert MTB/RIF was rarely available in Central Africa and South America. In sites with access to these diagnostics, microscopy was used in 745 (76%) patients diagnosed with TB, culture in 220 (24%), and chest X-ray in 688 (70%) patients. When free of charge culture was done in 27% of patients, compared to 21% when there was a fee (p = 0.033). Corresponding percentages for Xpert MTB/RIF were 26% and 15% of patients (p = 0.001). Screening practices for active disease before starting ART included symptom screening (46 sites, 98%), chest X-ray (38, 81%), sputum microscopy (37, 79%), culture (16, 34%), and Xpert MTB/RIF (5, 11%).
Conclusions: Mycobacterial culture was infrequently used despite its availability at most sites, while Xpert MTB/RIF was not generally available. Use of available diagnostics was higher when offered free of charge.
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معلومات مُعتمدة: U01AI069924 United States AI NIAID NIH HHS; U01 AI096299 United States AI NIAID NIH HHS; U01 AI069923 United States AI NIAID NIH HHS; U01AI069907 United States AI NIAID NIH HHS; U01AI069911 United States AI NIAID NIH HHS; U01A096299 United States PHS HHS; U01 AI069911 United States AI NIAID NIH HHS; U01AI069919 United States AI NIAID NIH HHS; U01 AI069919 United States AI NIAID NIH HHS; U01AI069923 United States AI NIAID NIH HHS; U01 AI069924 United States AI NIAID NIH HHS; K24 AI065298 United States AI NIAID NIH HHS; U01 AI069907 United States AI NIAID NIH HHS
المشرفين على المادة: 0 (Anti-Retroviral Agents)
تواريخ الأحداث: Date Created: 20131023 Date Completed: 20140605 Latest Revision: 20211021
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC3798412
DOI: 10.1371/journal.pone.0077697
PMID: 24147059
قاعدة البيانات: MEDLINE
الوصف
تدمد:1932-6203
DOI:10.1371/journal.pone.0077697