title: Multidrug-resistant tuberculosis at an HIV testing center in Haiti.
abstract: OBJECTIVE
  Tuberculosis is the major opportunistic infection of HIV/AIDS in developing countries. We investigated the prevalence rate of multidrug-resistant (MDR) tuberculosis at an HIV voluntary counseling and testing (VCT) center in Port-au-Prince, Haiti.
  
  
  METHODS
  A cross-sectional prevalence study of MDR-tuberculosis was conducted at a VCT Center. All patients reporting at least 5 days of cough were screened for tuberculosis, including sputum culture. All Mycobacteria tuberculosis isolates underwent drug susceptibility testing.
  
  
  RESULTS
  Between January 2000 and December 2002, isolates from 330 patients underwent drug susceptibility testing. MDR-tuberculosis was documented in 16 (6%) of 281 patients with primary tuberculosis and 10 (20%) of 49 patients with recurrent tuberculosis. In patients with primary disease, 11 (10%) of 115 HIV-infected patients had MDR-tuberculosis compared with five (3%) of 166 HIV-negative patients, (risk ratio 3.2; 95% confidence interval 1.1-8.9; P = 0.0331).
  
  
  CONCLUSIONS
  Multidrug resistance was prevalent among patients found to have pulmonary tuberculosis at an HIV testing center in Port-au-Prince. Patients with primary pulmonary tuberculosis who were HIV-co-infected were more likely to have multidrug resistance than HIV-negative patients. Assiduous attention to tuberculosis infection control measures at HIV testing centers in developing countries is critical to prevent nosocomial MDR-tuberculosis transmission. Measures may include appropriate ventilation, outdoor seating, ultra-violet lights, and rapid on-site screening for tuberculosis.
authors.affiliation: Groupe Haïtien d'étude du sarcome de Kaposi et des Infections opportunistes, Port-au-Prince, Haiti.
authors.forename: Patrice
authors.initials: P
authors.lastname: Joseph
authors.forename: Patrice
authors.initials: P
authors.lastname: Severe
authors.forename: Severine
authors.initials: S
authors.lastname: Ferdinand
authors.forename: Kye Seng
authors.initials: KS
authors.lastname: Goh
authors.forename: Christophe
authors.initials: C
authors.lastname: Sola
authors.forename: David W
authors.initials: DW
authors.lastname: Haas
authors.forename: Warren D
authors.initials: WD
authors.lastname: Johnson
authors.forename: Nalin
authors.initials: N
authors.lastname: Rastogi
authors.forename: Jean W
authors.initials: JW
authors.lastname: Pape
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Fitzgerald
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology*; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D012008:Recurrence; D012307:Risk Factors; D018088:Tuberculosis, Multidrug-Resistant / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000453:epidemiology*