Integration of tuberculosis screening at an HIV voluntary counselling and testing centre in Haiti
Integration of tuberculosis screening at an HIV voluntary counselling and testing centre in Haiti
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DOI：
10.1097/00002030-200109280-00018
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发表时间：
2001-09-28
期刊：
影响因子：
3.8
通讯作者：
Pape, JW
中科院分区：
文献类型：
--
作者：
Burgess, AL;Fitzgerald, DW;Pape, JW
目的：描述整合结核病筛查到活动中的艾滋病毒自愿咨询和检测（VCT）中心在一个国家与地方性tuberculosis.Setting：艾滋病毒VCT中心在港Au Prince，Haiti.Design：所有的患者提出艾滋病毒VCT谁报告咳嗽收到同一天的活动性结核病的评价。在1327名成年人提出的第一次在1997年1月至4月的中心，263（20%）报告咳嗽，这241（92%）evaluated.Results：在241例咳嗽评价，76（32%）被诊断为肺结核。在76例确诊为肺结核的患者中，28例（37%）抗酸杆菌（AFB）涂片阳性，14例（18%）AFB涂片阴性但痰结核分枝杆菌培养阳性，34例（45%）培养阴性。此外，31 241（13%）的VCT客户评价咳嗽被诊断为细菌性pneumonia.Conclusion：本报告证实，在艾滋病毒和结核病的高患病率的地区，高比例的VCT客户有活动性肺结核。结核病筛查的一体化有几个好处，包括诊断和治疗大量结核病患者，降低结核病医院传播的风险，并有机会向已排除结核病的艾滋病毒阳性患者提供结核病预防。今后需要开展研究，以确定结核病和艾滋病毒VCT综合服务的成本效益，以及是否应建议在艾滋病毒和结核病发病率高的所有国家进行综合服务。(C)2001年利平科特威廉姆斯&威尔金斯。
Objective: To describe the integration of tuberculosis screening into the activities of an HIV voluntary counselling and testing (VCT) centre in a country with endemic tuberculosis.Setting: An HIV VCT centre in Port au Prince, Haiti.Design: All patients presenting for HIV VCT who reported cough received same-day evaluation for active tuberculosis. Of the 1327 adults presenting to the centre for the first time between January and April 1997, 263 (20%) reported cough and of these 241 (92%) were evaluated.Results: Of the 241 patients evaluated for cough, 76 (32%) were diagnosed with pulmonary tuberculosis. Of the 76 patients diagnosed with pulmonary tuberculosis, 28 (37%) had a positive smear for acid-fast bacilli (AFB), 14 (18%) had a negative AFB smear but a positive sputum culture for Mycobacterium tuberculosis, and 34 (45%) had culture-negative tuberculosis. Also, 31 out of 241 (13%) VCT clients evaluated for cough were diagnosed with bacterial pneumonia.Conclusion: This report confirms that in areas with a high HIV and tuberculosis prevalence, a high proportion of VCT clients have active pulmonary tuberculosis. The integration of tuberculosis screening offers several benefits, including the diagnosis and treatment of large numbers of individuals with tuberculosis, a decreased risk of nosocomial tuberculosis transmission, and the opportunity to provide tuberculosis prophylaxis to HIV-positive patients in whom tuberculosis has been excluded. Future studies are needed to determine the cost-effectiveness of integrated tuberculosis and HIV VCT services, and whether integration should be recommended in all countries with high HIV and tuberculosis rates. (C) 2001 Lippincott Williams & Wilkins.