TB diagnostic capacity in sub-Saharan African HIV care settings.
As HIV care services continue to scale-up in sub-Saharan Africa, adequate tuberculosis diagnostic capacity is vital to reduce mortality among HIV-infected persons. A structured survey was administered at 663 health facilities providing HIV care to 908,043 patients in across 9 sub-Saharan African countries to estimate the proportion of facilities and HIV patients at these facilities with access TB-related diagnostic tests. Sputum smear microscopy was available at 87% of facilities (representing 97% of patients), chest x-ray at 26% of facilities (representing 56% of patients), tuberculin skin tests were available at 12% of facilities (representing 33% of patients). Acid-fast bacillus culture was available on-/off-site at 53% of facilities (representing 77% of patients). Primary health facilities had lower availability of tuberculosis diagnostic tests compared with secondary and tertiary health facilities. As HIV care continues to decentralize to primary health facilities, a corresponding expansion of diagnostic capacity to lower levels of the health system will be essential.
ICAP, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. ss1117@columbia.edu
Suzue
S
Saito
Andrea A
AA
Howard
Michael J A
MJ
Reid
Batya
B
Elul
Anna
A
Scardigli
Sabine
S
Verkuijl
Alaine U
AU
Nyaruhirira
Denis
D
Nash
D017954:Africa South of the Sahara; D019411:Clinical Laboratory Techniques / Q000379:methods* / Q000706:statistics & numerical data; D003954:Diagnostic Services / Q000706:statistics & numerical data*; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D014376:Tuberculosis / Q000175:diagnosis*