ArticlePloS one2014
High uptake of systematic HIV counseling and testing and TB symptom screening at a primary care clinic in South Africa.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.
- High HIV and active tuberculosis prevalence and increased mortality risk in adults with symptoms of TB: a systematic review and meta-analyses.Journal of the International AIDS Society · 2018Pooled it
- Pooled it
- Prevalence and associated risk factors of self-reported symptoms suggestive of female genital schistosomiasis (FGS) among women in KwaZulu-Natal, South Africa.PLoS neglected tropical diseases · 2026Article
- Strengthening HIV Programs in Sub-Saharan Africa Through Implementation Research: A Mixed-Methods Systematic Review.AIDS research and treatment · 2026Review
- Frequency of tuberculosis symptoms at repeat visits amongst adults attending for HIV care in Gauteng province, South Africa.BMC public health · 2025Article
- Diagnosis of Human Immunodeficiency Virus Infection.Clinical microbiology reviews · 2019Review
- Article
- Completion of the tuberculosis care cascade in a community-based HIV linkage-to-care study in South Africa and Uganda.Journal of the International AIDS Society · 2018Article
- Implementation and Operational Research: Use of Symptom Screening and Sputum Microscopy Testing for Active Tuberculosis Case Detection Among HIV-Infected Patients in Real-World Clinical Practice in Uganda.Journal of acquired immune deficiency syndromes (1999) · 2016Article
- Article
- Tuberculosis screening in patients with HIV: use of audit and feedback to improve quality of care in Ghana.Global health actionArticle
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundTimely diagnosis and treatment of tuberculosis (TB) and HIV is important to reduce morbidity and mortality, and break the cycle of ongoing transmission.
methodsWe performed an implementation research study to develop a model for systematic TB symptom screening and HIV counseling and testing (HCT) for all adult clients at a primary care clinic and prospectively evaluate the 6-month coverage and yield, and 18-month sustainability at a primary care clinic in Johannesburg, South Africa.
resultsDuring the first 6 months, 26,515 visits occurred among 12,078 adults. The proportion of adults aware of their HIV status was 43.7% at the start of the first visit, increased to 84.6% at the end of the first visit, and to 90% at end of any visit during the first 6 months. During these 6 months, 1042 clients were newly diagnosed with HIV. HIV prevalence was 22.9% among those newly tested, and 58.9% among all adult clinic clients. High coverage of systematic HCT was sustained across all 18 months. Coverage of systematic HIV-stratified TB symptom screening during first 6-months was also high (89.6%) but only 35.0% of those symptomatic were screened by sputum. During these 6-months, 90 clients had a positive Xpert MTB/RIF assay, corresponding to a TB prevalence of 0.4% among all 23,534 clients TB symptom-screened and 2.8% among the 3,284 clients with a positive TB symptom screen. The initial high coverage of TB symptom screening was not sustained, with coverage of TB symptom screening dropping after the first six months to 70% and assessment by sputum dropping to 15%.
conclusionRoutine, systematic HCT and HIV-stratified TB symptom screening is feasible at primary care level. Systematic HCT doubled the proportion of clients with known HIV status. While HCT was sustainable, coverage of systematic TB screening dropped significantly after the first 6 months of implementation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.