title: Integration of tuberculosis screening at an HIV voluntary counselling and testing centre in Haiti.
abstract: OBJECTIVE
  To describe the integration of tuberculosis screening into the activities of an HIV voluntary counselling and testing (VCT) centre in a country with endemic tuberculosis.
  
  
  METHODS
  An HIV VCT centre in Port au Prince, Haiti.
  
  
  METHODS
  All patients presenting for HIV VCT who reported cough received same-day evaluation for active tuberculosis. Of the 1327 adults presenting to the centre for the first time between January and April 1997, 263 (20%) reported cough and of these 241 (92%) were evaluated.
  
  
  RESULTS
  Of the 241 patients evaluated for cough, 76 (32%) were diagnosed with pulmonary tuberculosis. Of the 76 patients diagnosed with pulmonary tuberculosis, 28 (37%) had a positive smear for acid-fast bacilli (AFB), 14 (18%) had a negative AFB smear but a positive sputum culture for Mycobacterium tuberculosis, and 34 (45%) had culture-negative tuberculosis. Also, 31 out of 241 (13%) VCT clients evaluated for cough were diagnosed with bacterial pneumonia.
  
  
  CONCLUSIONS
  This report confirms that in areas with a high HIV and tuberculosis prevalence, a high proportion of VCT clients have active pulmonary tuberculosis. The integration of tuberculosis screening offers several benefits, including the diagnosis and treatment of large numbers of individuals with tuberculosis, a decreased risk of nosocomial tuberculosis transmission, and the opportunity to provide tuberculosis prophylaxis to HIV-positive patients in whom tuberculosis has been excluded. Future studies are needed to determine the cost-effectiveness of integrated tuberculosis and HIV VCT services, and whether integration should be recommended in all countries with high HIV and tuberculosis rates.
authors.affiliation: Cornell University Medical College, New York, NY, USA.
authors.forename: A L
authors.initials: AL
authors.lastname: Burgess
authors.forename: D W
authors.initials: DW
authors.lastname: Fitzgerald
authors.forename: P
authors.initials: P
authors.lastname: Severe
authors.forename: P
authors.initials: P
authors.lastname: Joseph
authors.forename: E
authors.initials: E
authors.lastname: Noel
authors.forename: N
authors.initials: N
authors.lastname: Rastogi
authors.forename: W D
authors.initials: WD
authors.lastname: Johnson
authors.forename: J W
authors.initials: JW
authors.lastname: Pape
mesh_terms: D015492:AIDS Serodiagnosis; D000328:Adult; D003376:Counseling; D019033:Delivery of Health Care, Integrated; D015658:HIV Infections / Q000453:epidemiology; D006205:Haiti; D006801:Humans; D008403:Mass Screening; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology