ArticlePloS one2016
Performance of Clinical Screening Algorithms for Tuberculosis Intensified Case Finding among People Living with HIV in Western Kenya.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 8 of them syntheses that pooled it.
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Who cites it
32 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Number Needed to Screen for Tuberculosis Disease Among Children: A Systematic Review.Pediatrics · 2023Pooled it
- Xpert MTB/RIF Ultra assay for tuberculosis disease and rifampicin resistance in children.The Cochrane database of systematic reviews · 2022Pooled it
- Tuberculosis screening among ambulatory people living with HIV: a systematic review and individual participant data meta-analysis.The Lancet. Infectious diseases · 2022Pooled it
- A systematic review of the number needed to screen for active TB among people living with HIV.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2021Pooled it
- Xpert MTB/RIF and Xpert Ultra assays for screening for pulmonary tuberculosis and rifampicin resistance in adults, irrespective of signs or symptoms.The Cochrane database of systematic reviews · 2021Pooled it
- Xpert Ultra versus Xpert MTB/RIF for pulmonary tuberculosis and rifampicin resistance in adults with presumptive pulmonary tuberculosis.The Cochrane database of systematic reviews · 2021Pooled it
- Xpert MTB/RIF and Xpert MTB/RIF Ultra assays for active tuberculosis and rifampicin resistance in children.The Cochrane database of systematic reviews · 2020Pooled it
- Xpert MTB/RIF and Xpert MTB/RIF Ultra for pulmonary tuberculosis and rifampicin resistance in adults.The Cochrane database of systematic reviews · 2019Pooled it
- Subclinical tuberculosis among adults with HIV: clinical features and outcomes in a South African cohort.BMC infectious diseases · 2019Trial
- Prevalence and burden of HIV-TB co-infection among pregnant women: A systematic review and meta-analysis.Journal of Taibah University Medical Sciences · 2026Review
- A public-private partnership for facility-based tuberculosis screening using chest radiographs, Viet Nam.Bulletin of the World Health Organization · 2026Article
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- Article
- Results of community-based TB and HIV screening among transgender women and male sex workers in Pakistan.PLOS global public health · 2023Article
- The clinical presentation and detection of tuberculosis during pregnancy and in the postpartum period in low- and middle-income countries: A systematic review and meta-analysis.PLOS global public health · 2023Article
- Landscape of TB Infection and Prevention among People Living with HIV.Pathogens (Basel, Switzerland) · 2022Review
- Factors Associated with Treatment Outcomes Among Children and Adolescents Living with HIV Receiving Antiretroviral Therapy in Central Kenya.AIDS research and human retroviruses · 2022Article
- Diagnostic performance of oral swabs for non-sputum based TB diagnosis in a TB/HIV endemic setting.PloS one · 2022Article
- Pulmonary tuberculosis screening in anti-retroviral treated adults living with HIV in Kenya.BMC infectious diseases · 2021Article
- Tuberculosis preventive treatment opportunities at antiretroviral therapy initiation and follow-up visits.Public health action · 2020Article
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Authors and funding
10 authors.
Funding
Abstract
objectiveTo assess the performance of symptom-based screening for tuberculosis (TB), alone and with chest radiography among people living with HIV (PLHIV), including pregnant women, in Western Kenya.
designProspective cohort study.
methodsPLHIV from 15 randomly-selected HIV clinics were screened with three clinical algorithms [World Health Organization (WHO), Ministry of Health (MOH), and "Improving Diagnosis of TB in HIV-infected persons" (ID-TB/HIV) study], underwent chest radiography (unless pregnant), and provided two or more sputum specimens for smear microscopy, liquid culture, and Xpert MTB/RIF. Performance of clinical screening was compared to laboratory results, controlling for the complex design of the survey.
resultsOverall, 738 (85.6%) of 862 PLHIV enrolled were included in the analysis. Estimated TB prevalence was 11.2% (95% CI, 9.9-12.7). Sensitivity of the three screening algorithms was similar [WHO, 74.1% (95% CI, 64.1-82.2); MOH, 77.5% (95% CI, 68.6-84.5); and ID-TB/HIV, 72.5% (95% CI, 60.9-81.7)]. Sensitivity of the WHO algorithm was significantly lower among HIV-infected pregnant women [28.2% (95% CI, 14.9-46.7)] compared to non-pregnant women [78.3% (95% CI, 67.3-86.4)] and men [77.2% (95% CI, 68.3-84.2)]. Chest radiography increased WHO algorithm sensitivity and negative predictive value to 90.9% (95% CI, 86.4-93.9) and 96.1% (95% CI, 94.4-97.3), respectively, among asymptomatic men and non-pregnant women.
conclusionsClinical screening missed approximately 25% of laboratory-confirmed TB cases among all PLHIV and more than 70% among HIV-infected pregnant women. National HIV programs should evaluate the feasibility of laboratory-based screening for TB, such as a single Xpert MTB/RIF test for all PLHIV, especially pregnant women, at enrollment in HIV services.
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