ArticleOpen forum infectious diseases2014
A Clinical Scoring Algorithm for Determination of the Risk of Tuberculosis in HIV-Infected Adults: A Cohort Study Performed at Ethiopian Health Centers.
Article in Open forum infectious diseases, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01433796 (Tuberculosis in HIV-infected Patients Managed in Health Centres in Ethiopia - Identification of a Screening Algorithm for Active Tuberculosis and Determination of Outcome of Combined Antituberculosis and Antiretroviral Treatment), which is not on this map. Cited by 26 papers, 2 of them syntheses that pooled it.
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Tuberculosis in HIV-infected Patients Managed in Health Centres in Ethiopia - Identification of a Screening Algorithm for Active Tuberculosis and Determination of Outcome of Combined Antituberculosis and Antiretroviral Treatment
Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Clinical utility of WHO-recommended screening tools and development and validation of novel clinical prediction models for pulmonary tuberculosis screening among outpatients living with HIV: an individual participant data meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2023Pooled it
- Tuberculosis screening among ambulatory people living with HIV: a systematic review and individual participant data meta-analysis.The Lancet. Infectious diseases · 2022Pooled it
- Development and validation of a machine learning model for community-based tuberculosis screening among persons aged ≥ 15 years in South Africa and Zambia.medRxiv : the preprint server for health sciences · 2026Article
- A clinical scoring system to predict tuberculous lymphadenitis in settings with high disease burden.Scientific reports · 2025Article
- Development and validation of a risk prediction model for pulmonary tuberculosis in presumptive tuberculosis patients in Tigray, northern Ethiopia.Scientific reports · 2025Article
- Bridging the gap: Early detection of pulmonary tuberculosis among PLHIV in Western Rajasthan, India.Lung India : official organ of Indian Chest Society · 2025Article
- Clinically diagnosed tuberculosis and mortality in high burden settings: a systematic review and meta-analysis.EClinicalMedicine · 2025Article
- Potential Utility of C-reactive Protein for Tuberculosis Risk Stratification Among Patients With Non-Meningitic Symptoms at HIV Diagnosis in Low- and Middle-income Countries.Open forum infectious diseases · 2024Article
- Predictors contributing to the estimation of pulmonary tuberculosis among adults in a resource-limited setting: A systematic review of diagnostic predictions.SAGE open medicine · 2024Review
- LSTM-Based Prediction Model for Tuberculosis Among HIV-Infected Patients Using Structured Electronic Medical Records: A Retrospective Machine Learning Study.Journal of multidisciplinary healthcare · 2024Article
- Development and validation of a risk prediction model for pulmonary tuberculosis among presumptive tuberculosis cases in Ethiopia.BMJ open · 2023Article
- Predicting the risk of active pulmonary tuberculosis in people living with HIV: development and validation of a nomogram.BMC infectious diseases · 2022Article
- Clinical predictors of pulmonary tuberculosis among South African adults with HIV.EClinicalMedicine · 2022Article
- Derivation and external validation of a risk score for predicting HIV-associated tuberculosis to support case finding and preventive therapy scale-up: A cohort study.PLoS medicine · 2021Article
- A clinical score for identifying active tuberculosis while awaiting microbiological results: Development and validation of a multivariable prediction model in sub-Saharan Africa.PLoS medicine · 2020Article
- Apoptosis in peripheral blood lymphocytes in intestinal tuberculosis and Crohn's disease: Implications to diagnostic differentiation.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2020Article
- Determine TB-LAM point-of-care tuberculosis assay predicts poor outcomes in outpatients during their first year of antiretroviral therapy in South Africa.BMC infectious diseases · 2020Article
- A Clinical Prediction Score Including Trial of Antibiotics and C-Reactive Protein to Improve the Diagnosis of Tuberculosis in Ambulatory People With HIV.Open forum infectious diseases · 2020Article
- Plasma Profiles of Inflammatory Markers Associated With Active Tuberculosis in Antiretroviral Therapy-Naive Human Immunodeficiency Virus-Positive Individuals.Open forum infectious diseases · 2019Article
- What causes symptoms suggestive of tuberculosis in HIV-positive people with negative initial investigations?The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2019Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe World Health Organization (WHO) tuberculosis (TB) symptom screening instrument (WHO-TB) can identify human immunodeficiency virus (HIV)-infected individuals at low risk of tuberculosis (TB); however, many patients report WHO-TB symptoms and require further TB investigations. We hypothesized that further clinical scoring could classify subjects with a positive WHO-TB screening result (WHO-TB(+)) for the likelihood of TB.
methodsHIV-infected adults eligible to initiate antiretroviral therapy (ART) were recruited and prospectively followed at 5 Ethiopian health centers. Irrespective of symptoms, all participants underwent sputum bacteriological testing for TB. Symptoms, physical findings, hemoglobin, and CD4 cell count results were compared between subjects with and those without bacteriologically confirmed TB. Variables associated with TB in WHO-TB(+) individuals were used to construct a scoring algorithm with multiple logistic regression analysis.
resultsAmong 812 participants, 137 (16.9%) had TB. One hundred fifty-nine persons (20%) had a negative WHO-TB screen, 10 of whom had TB (negative predictive value [NPV], 94% [95% confidence interval {CI}, 90%-97.5%]). For WHO-TB(+) subjects, the following variables were independently associated with TB, and were assigned 1 point each in the clinical scoring algorithm: cough, Karnofsky score ≤80, mid-upper arm circumference <20 cm, lymphadenopathy, and hemoglobin <10 g/dL. Among subjects with 0-1 points, 20 of 255 had TB (NPV, 92% [95% CI, 89%-95%]), vs 19 of 34 participants with ≥4 points (positive predictive value, 56% [95% CI, 39%-73%]). The use of WHO-TB alone identified 159 of 784 (20%) with a low risk of TB, vs 414 of 784 (53%) using WHO-TB followed by clinical scoring (P< .001). The difference in proportions of confirmed TB in these subsets was nonsignificant (6.3% vs 7.2%; P= .69).
conclusionsClinical scoring can further classify HIV-infected adults with positive WHO-TB screen to assess the risk of TB, and would reduce the number of patients in need of further TB investigations before starting ART. CLINICAL TRIALS REGISTRATION: NCT01433796.
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