Improving the diagnosis of pulmonary tuberculosis in HIV-infected individuals in Ho Chi Minh City, Viet Nam

Duc Tan Minh Nguyen, N. Q. Hung, L. T. Giang, N. H. Dung, N. T.N. Lan, N. N. Lan, N. T.B. Yen, N. D. Bang, D. V. Ngoc, L. T.T. Trinh, R. P. Beasley, C. E. Ford, L. Y. Hwang, Edward A. Graviss

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

SETTING: District 6, An Hoa Clinic in Ho Chi Minh City (HCMC), Viet Nam. OBJECTIVE: To evaluate the performance of various algorithms in tuberculosis (TB) screening and diagnosis in a human immunodeficiency virus (HIV) infected population in HCMC, Viet Nam. DESIGN: A cross-sectional study of 397 consecutive HIV-infected patients seeking care at the An Hoa Clinic from August 2009 to June 2010. Data on participant demographics, clinical status, chest radiography (CXR) and laboratory results were collected. A multiple logistic regression model was developed to assess the association of covariates and pulmonary TB (PTB). RESULTS: The prevalence of sputum culture-confirmed PTB, acid-fast bacilli (AFB) positive TB, and multidrugresistant TB among the 397 HIV-infected patients was respectively 7%, 2%, and 0.3%. Adjusted odds ratios for low CD4+ cell count, positive sputum smear, and CXR to positive sputum culture were respectively 3.17, 32.04 and 4.28. Clinical findings alone had poor sensitivity, but combining CD4+ cell count, AFB sputum smear and CXR had a more accurate diagnostic performance. CONCLUSION: Results suggest that symptom screening had poor clinical performance, and support the routine use of sputum culture to improve the detection of TB disease in HIV-infected individuals in Viet Nam. However, when routine sputum culture is not available, an algorithm combining CD4+ cell count, AFB sputum smear and CXR is recommended for diagnosing PTB.

Original languageEnglish (US)
Pages (from-to)1528-1534
Number of pages7
JournalInternational Journal of Tuberculosis and Lung Disease
Volume15
Issue number11
DOIs
StatePublished - Nov 2011

Keywords

  • AFB smear-negative
  • Culture-positive
  • HIV-infected
  • Tuberculosis
  • Viet Nam

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

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