Population-Based Active TB Case Finding During Large-Scale Mobile HIV Testing Campaigns in Rural Uganda

October 2016 - Combination Prevention

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Ssemmondo, E., Mwangwa, F., Kironde, J.L., et al. Journal of Acquired Immune Deficiency Syndromes, epub ahead of print (2016), doi: 10.1097/QAI.0000000000001142.

The authors of this study conducted integrated multi-disease community campaigns, including HIV and tuberculosis (TB) testing and screening, in seven rural Ugandan communities, and examined TB screening yield and TB treatment outcomes. The campaigns comprised a community census, a two-week public rapid HIV test and TB symptom screening campaign, and household follow-up for those not yet accessing testing and screening services. Individuals with positive TB symptoms provided sputum samples at the campaign; these were evaluated by a lab the same day. Those with positive sputum results were directed to come to the clinic for treatment within 24 hours. A total of 2,876 individuals reported persistent (>2 weeks) cough, but only 1,099 individuals provided sputum samples. Of these, 10 adults were identified as having TB; nine were newly diagnosed. TB screening yield for newly diagnosed individuals with persistent cough was 9/2,876. To identify one new individual with TB through sputum microscopy, 320 had to be screened for those with persistent cough, and 80 for those who were HIV-positive with persistent cough. This approach successfully integrated TB case finding through an integrated community campaign. Nine individuals diagnosed with TB were enrolled in TB services; six successfully completed treatment; one experienced treatment failure and started second-line therapy, one was lost to follow-up, and one died from other causes.

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