HIV Testing among Patients with Presumptive Tuberculosis: How Do We Implement in a Routine Programmatic Setting? Results of a Large Operational Research from India

作者：Ajay Kumar, Ajay Kumar, Devesh Gupta, Ashok Kumar, Ashok Kumar, Radhey S. Gupta, Avinash Kanchar, Raghuram Rao, Suresh Shastri, M D Suryakanth, Chethana Rangaraju, Balaji Naik, Deepak K. Guddemane, P. Bhat, Sreenivas Achuthan Nair, Anthony Harries, Puneet Dewan · 发表于：PLoS ONE · 年份：2016 · DOI：10.1371/journal.pone.0156487 · 被引用次数：24 · 研究领域：Tuberculosis Research and Epidemiology、Pneumocystis jirovecii pneumonia detection and treatment、Diagnosis and treatment of tuberculosis

BACKGROUND: In March 2012, World Health Organization recommended that HIV testing should be offered to all patients with presumptive TB (previously called TB suspects). How this is best implemented and monitored in routine health care settings in India was not known. An operational research was conducted in Karnataka State (South India, population 64 million, accounts for 10% of India's HIV burden), to test processes and learn results and challenges of screening presumptive TB patients for HIV within routine health care settings. METHODS: In this cross-sectional study conducted between January-March 2012, all presumptive TB patients attending public sector sputum microscopy centres state-wide were offered HIV testing by the laboratory technician, and referred to the nearest public sector HIV counselling and testing services, usually within the same facility. The HIV status of the patients was recorded in the routine TB laboratory form and TB laboratory register. The laboratory register was compiled to obtain the number of presumptive TB patients whose HIV status was ascertained, and the number found HIV positive. Aggregate data on reasons for non-testing were compiled at district level. RESULTS: Overall, 115,308 patients with presumptive TB were examined for sputum smear microscopy at 645 microscopy centres state-wide. Of these, HIV status was ascertained for 62,847(55%) among whom 7,559(12%) were HIV-positive, and of these, 3,034(40%) were newly diagnosed. Reasons for non-te...