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Journal Article > Research

Symptom screen: diagnostic usefulness in detecting pulmonary tuberculosis in HIV-infected pregnant women in Kenya

Kosgei RJ, Ndavi PM, Ong’ech JO, Abuya JM, Siika AM, Wools-Kaloustian K, Mabeya H, Fojo T, Mwangi A, Reid AJ, Edginton ME, Carter EJ
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Abstract
OBJECTIVE
To determine the diagnostic usefulness of tuberculosis (TB) symptom screening to detect active pulmonary TB among human immunodeficiency virus (HIV) infected pregnant women in two PMTCT (prevention of mother-to-child transmission) clinics in western Kenya that are supported by the United States Agency for International Development-Academic Model Providing Access to Healthcare partnership.

DESIGN
Cross-sectional study. Participants were interviewed for TB symptoms with a standardized questionnaire (cough >2 weeks, fever, night sweats, weight loss or failure to gain weight). Those with cough submitted sputum specimens for smear microscopy for acid-fast bacilli and mycobacterial culture. Women at >14 weeks gestation underwent shielded chest radiography (CXR).

RESULTS
Of 187 HIV-infected women, 38 (20%) were symptom screen-positive. Of these, 21 had a cough for >2 weeks, but all had negative sputum smears and mycobacterial cultures. CXRs were performed in 26 symptomatic women: three were suggestive of TB (1 miliary, 1 infiltrates and 1 cavitary). Of 149 women with a negative symptom screen, 100 had a CXR and seven had a CXR suggestive of TB (1 cavitary, 2 miliary and 4 infiltrates).

CONCLUSION
This study did not support the utility of isolated symptom screening in identification of TB disease in our PMTCT setting. CXR was useful in identification of TB suspects in both symptomatic and asymptomatic women.
Countries
Kenya
Subject Area
tuberculosiswomen's healthdiagnosticsHIV/AIDSfilovirus
DOI
10.5588/pha.11.0004
Published Date
26-Oct-2011
PubMed ID
26392933
Languages
English
Journal
Public Health Action
Volume / Issue / Pages
Volume 1, Issue 2, Pages 30-3
Issue Date
01-Dec-2011
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