ArticleAmerican journal of respiratory and critical care medicine2019
Yield and Efficiency of Novel Intensified Tuberculosis Case-Finding Algorithms for People Living with HIV.
Article in American journal of respiratory and critical care medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04557176 (TB Screening Improves Preventive Therapy Uptake Trial), which is not on this map. Cited by 29 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
TB Screening Improves Preventive Therapy Uptake Trial
Who cites it
29 citing papers in PubMed, 5 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Parallel use of low-complexity automated nucleic acid amplification tests and lateral flow urine lipoarabinomannan assays to detect tuberculosis disease in adults and adolescents living with HIV.The Cochrane database of systematic reviews · 2025Pooled it
- Yield and Efficiency of a Population-Based Mass Tuberculosis Screening Intervention Among Persons With Diabetes in Jiangsu Province, China.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 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
- Tuberculosis screening costs and cost-effectiveness in high-risk groups: a systematic review.BMC infectious diseases · 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
- Predictive Value of C-reactive Protein for Hospitalization and Mortality Among People With Advanced HIV Disease in Uganda Receiving the World Health Organization-recommended Package of Care.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Clinical impact and cost-effectiveness of the WHO-recommended advanced HIV disease package of care.The Lancet. Global health · 2025Article
- Sex differences in systematic screening for tuberculosis among antiretroviral therapy naïve people with HIV in Kampala, Uganda.BMC infectious diseases · 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
- The impact of COVID-19 pandemic in tuberculosis diagnosis in sub-Saharan Africa: data from DREAM program in Mozambique.African health sciences · 2024Article
- C-reactive protein and procalcitonin use in adults in low- and middle-income countries: a narrative review.JAC-antimicrobial resistance · 2023Review
- Diagnosis and treatment of tuberculosis in adults with HIV.Medicine · 2022Review
- The Role of C-Reactive Protein as a Triage Tool for Pulmonary Tuberculosis in Children.Journal of the Pediatric Infectious Diseases Society · 2022Article
- Article
- Trends of notification rates and treatment outcomes of tuberculosis cases with and without HIV co-infection in eight rural districts of Uganda (2015 - 2019).BMC public health · 2022Article
- Clinical predictors of pulmonary tuberculosis among South African adults with HIV.EClinicalMedicine · 2022Article
- Article
- Blood-based host biomarker diagnostics in active case finding for pulmonary tuberculosis: A diagnostic case-control study.EClinicalMedicine · 2021Article
- Impact of hematocrit on point-of-care C-reactive protein-based tuberculosis screening among people living with HIV initiating antiretroviral therapy in Uganda.Diagnostic microbiology and infectious disease · 2021Article
- Evaluation of the diagnostic performance of laboratory-based c-reactive protein as a triage test for active pulmonary tuberculosis.PloS one · 2021Article
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Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
Abstract
rationaleThe recommended tuberculosis (TB) intensified case finding (ICF) algorithm for people living with HIV (symptom-based screening followed by Xpert MTB/RIF [Xpert] testing) is insufficiently sensitive and results in unnecessary Xpert testing.
objectivesTo evaluate whether novel ICF algorithms combining C-reactive protein (CRP)-based screening with urine Determine TB-LAM (TB-LAM), sputum Xpert, and/or sputum culture could improve ICF yield and efficiency.
methodsWe compared the yield and efficiency of novel ICF algorithms inclusive of point-of-care CRP-based TB screening and confirmatory testing with urine TB-LAM (if CD4 count ≤100 cells/μl), sputum Xpert, and/or a single sputum culture among consecutive people living with HIV with CD4 counts less than or equal to 350 cells/μl initiating antiretroviral therapy in Uganda. MEASUREMENTS AND MAIN
resultsOf 1,245 people living with HIV, 203 (16%) had culture-confirmed TB including 101 (49%) patients with CD4 counts less than or equal to 100 cells/μl. Compared with the current ICF algorithm, point-of-care CRP-based TB screening followed by Xpert testing had similar yield (56% [95% confidence interval, 49-63] vs. 59% [95% confidence interval, 51-65]) but consumed less than half as many Xpert assays per TB case detected (9 vs. 4). Addition of TB-LAM did not significantly increase diagnostic yield relative to the current ICF algorithm but provided same-day diagnosis for 26% of TB patients with advanced HIV. Addition of a single culture to TB-LAM and Xpert substantially improved ICF yield, identifying 78% of all TB cases.
conclusionsPoint-of-care CRP-based screening can improve ICF efficiency among people living with HIV. Addition of TB-LAM and a single culture to Xpert confirmatory testing could enable HIV programs to increase the speed of TB diagnosis and ICF yield.
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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.