title: Aetiology of pulmonary symptoms in HIV-infected smear negative recurrent PTB suspects in Kampala, Uganda: a cross-sectional study.
abstract: BACKGROUND
  Previously treated TB patients with pulmonary symptoms are often considered recurrent TB suspects in the resource-limited settings, where investigations are limited to microscopy and chest x-ray. Category II anti-TB drugs may be inappropriate and may expose patients to pill burden, drug toxicities and drug-drug interactions.
  
  
  OBJECTIVE
  To determine the causes of pulmonary symptoms in HIV-infected smear negative recurrent pulmonary tuberculosis suspects at Mulago Hospital, Kampala.
  
  
  METHODS
  Between March 2008 and December 2011, induced sputum samples of 178 consented HIV-infected smear negative recurrent TB suspects in Kampala were subjected to MGIT and LJ cultures for mycobacteria at TB Reference Laboratory, Kampala. Processed sputum samples were also tested by PCR to detect 18S rRNA gene of P.jirovecii and cultured for other bacteria.
  
  
  RESULTS
  Bacteria, M. tuberculosis and Pneumocystis jirovecii were detected in 27%, 18% and 6.7% of patients respectively and 53.4% of the specimens had no microorganisms. S. pneumoniae, M. catarrhalis and H. influenzae were 100% susceptible to chloramphenicol and erythromycin but co-trimoxazole resistant.
  
  
  CONCLUSIONS
  At least 81.5% of participants had no microbiologically-confirmed TB. However our findings call for thorough investigation of HIV-infected smear negative recurrent TB suspects to guide cost effective treatment.
authors: Department of Internal Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
authors: Alphonse
authors: A
authors: Okwera
authors: Freddie
authors: F
authors: Bwanga
authors: Irene
authors: I
authors: Najjingo
authors: Yusuf
authors: Y
authors: Mulumba
authors: David K
authors: DK
authors: Mafigiri
authors: Christopher C
authors: CC
authors: Whalen
authors: Moses L
authors: ML
authors: Joloba
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000472:pathogenicity; D012337:RNA, Ribosomal, 18S / Q000235:genetics; D011795:Surveys and Questionnaires; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000209:etiology* / Q000378:metabolism; D014454:Uganda; D055815:Young Adult
chemical_list: D012337:RNA, Ribosomal, 18S