TB-testing capacity at HIV care centers varies by facility in Africa
Diagnostic tests for tuberculosis (TB) were more readily available at secondary- and tertiary-care facilities than in primary-care units in a survey of more than 600 facilities in 9 sub-Saharan African countries.
TB remains the leading cause of death in HIV-positive people across much of sub-Saharan Africa. Availability of adequate diagnostic capacity in HIV centers is critical to cutting mortality in HIV-positive people.
This structured survey involved 663 health facilities providing care for 908,043 HIV-positive people in 9 sub-Saharan countries. The goal was to estimate the proportion of facilities and HIV-positive people at those facilities with access to TB diagnostic tests.
Diagnostic tests were available at the following proportions of facilities for the noted proportions of HIV patients:
• Sputum smear microscopy: 87% of facilities, 97% of
patients
• Chest x-ray: 26% of facilities, 56% of patients
• Tuberculin skin test: 12% of facilities, 33% of
patients
• Acid-fast bacillus culture on or off site: 53% of
facilities, 77% of patients
Secondary- and tertiary-care centers offered TB diagnostic tests more often than primary-care facilities.
“As HIV care continues to decentralize to primary health facilities,” the authors stress, “a corresponding expansion of diagnostic capacity to lower levels of the health system will be essential.”
Source: Suzue Saito, Andrea A. Howard, Michael J.A. Reid, Batya Elul, Anna Scardigli, Sabine Verkuijl, Alaine U. Nyaruhirira, Denis Nash. TB diagnostic capacity in sub-Saharan African HIV care settings. JAIDS. 2012; 61: 216-220.
(Downloading the complete article requires a subscription to JAIDS or an online payment; the abstract is free.)
IAS
http://www.iasociety.org/Default.aspx?pageId=5&elementId=14776
