Chest Infections |

Active Tuberculosis Case Finding and Detection of Drug Resistance Among HIV-Infected Patients: A Cross-Sectional Study in a TB Endemic Area, Gondar, Northwest Ethiopia FREE TO VIEW

Martha Menberu, MS; Baye Tarekegn, PhD; Ebba Waktola, PhD; Liya Wassie, PhD; Russell R. Kempker, PhD; Henry M. Blumberg, PhD; Abraham Aseffa, PhD
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Department of Medical Microbiology, School of Biomedical and Laboratory Sciences, University of Gondar, Gondar, Ethiopia

Chest. 2015;148(4_MeetingAbstracts):142A. doi:10.1378/chest.2247718
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SESSION TITLE: Chest Infections Posters: Tuberculosis

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: To determine the prevalence of undiagnosed pulmonary tuberculosis cases through active case finding and including multidrug-resistant TB (MDR-TB) among HIV-infected patients.

METHODS: A total of 250 HIV-infected patients, aged 18 years and above were evaluated in a cross-sectional design between February 2012 and November 2012. Sociodemographic and clinical data were collected using a structured questionnaire. Sputum samples were collected from all participants for acid fast bacilli (AFB) direct smear microscopy and Mycobacteria culture. A PCR-based RD9 deletion and genus typing, as well as firstline anti-TB drug susceptibility testing, was performed for all culture-positive isolates.

RESULTS: Following active TB case finding, a total of 15/250 (6%) cases were diagnosed as TB cases, of whom 9/250 (3.6%) were detected by both smear microscopy and culture and the remaining 6/250 (2.4%) only by culture. All the 15 isolates were typed through RD9 typing of which 10 were Mycobacterium tuberculosis species; 1 belonged to Mycobacterium genus and 4 isolates were non-tuberculous mycobacteria. The prevalence of undiagnosed pulmonary TB disease among the study participants was 4.4%, which implies the possibility of identifying even more undiagnosed cases through active case finding. A multivariate logistic regression showed a statistically significant association between the presence of pneumonia infection and the occurrence of TB (OR = 4.81, 95% CI (1.08-21.43), p = 0.04). In addition, all the isolates were sensitive to all first-line anti-TB drugs, except for streptomycin, seen in only one newly diagnosed TB patient, and MDR-TB was not detected.

CONCLUSIONS: The prevalence of undiagnosed pulmonary TB infection among HIV-infected patients in Gondar was 4.4%. Additionally, the possibility of these undiagnosed TB cases in the community could also pose a risk for the transmission of the disease, particularly among family members.

CLINICAL IMPLICATIONS: Active screening of known HIV-infected individuals, with at least one TB symptom is recommended, even in persons with opportunistic infections.

DISCLOSURE: The following authors have nothing to disclose: Martha Menberu, Baye Tarekegn, Ebba Waktola, Liya Wassie, Russell R. Kempker, Henry M. Blumberg, Abraham Aseffa

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