Evaluation of sensitivity and specificity of tuberculosis diagnostic tools among HIV positive patients: A cross-sectional study
-
Yousef Alimohamadi
,
Parvin Afsar-kazerooni
,
Mojtaba Sepandi
,
Shahla Chaichian
,
Hamidreza Tabatabaee
,
Zahra Kashi
,
Manije Alimohammadi
,
Firooz Esmaeilzadeh
Abstract
Background & Aim: Tuberculosis is the major cause of morbidity and mortality among HIV patients. Thus, early diagnosis of Tuberculosis among these patients is important. The purpose of the present study was to determine the Sensitivity, Specificity, PPV and NPV for tools of diagnosing TB among HIV patients referred to behavioral disorder counseling center of Shiraz city.
Methods & Materials: In this cross sectional study, 250 HIV+ patients in Shiraz were evaluated. For each patient, three sputum smears and a Chest X-ray and PPD was taken. Sensitivity, specificity, and positive and negative predictive values were determined based on the results of sputum cultures as a gold standard.
Results: Among 250 HIV+ individuals who entered the study, 8 (3.2 %) were diagnosed with tuberculosis. The sensitivity, specificity, PPV and NPV for chest x-ray were 62.5%, 96%, 38% and 98.7%, respectively. Also they were 62.5%, 98.7%, 62.5% and 98.7% for AFB 1, and 25%, 99.5%, 66% and 97.5% for AFB 2. Finally, these factors were 99.5%, 99.5%, 66% and 97.5% for AFB 3.
Conclusion: The prevalence of TB among HIV+ patients referring to the behavioral disease counseling center in Shiraz was lower than in other endemic areas of developing countries. The screening tools for diagnosis of tuberculosis included the chest x-ray and Acid Fast Bacilli and PPD test in order to find out the important role of detecting TB disease among HIV-infected people.
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5.Tursynbayeva T, Idrissova M, Markabaeva T, Usenova G, Utepkaliyeva G, Akhmetova G, et al. Improving Surveillance on Tuberculosis and HIV Co-Infection in Kazakhstan. Open Infect Dis J. 2013;7(1):54-58.
6. Siawaya JFD, Ruhwald M, Eugen-Olsen J, Walzl G. Correlates for disease progression and prognosis during concurrent HIV/TB infection. Int Infect Dis. 2007;11(4):289-99.
7. Metcalfe JZ, Porco TC, Westenhouse J, Damesyn M, Facer M, Hill J, Xia Q, et al. Tuberculosis and HIV co-infection, California, USA, 1993–2008. Emerg Infect Dis. 2013;19(3):400-6.
8. Pawlowski A, Jansson M, Scold M, Rottenberg ME, Kallenius G. Tuberculosis and HIV coinfection. PLoS Pathogens. 2012;8(2): 1-7.
9. Pontali E, Pasticci M, Matteelli A, Baldelli F, Migliori GB. Tuberculosis and HIV co-infection: do we have a surveillance system in Europe? Eur Respir J. 2011;38(6):1258-60.
10. Esmael A, Tsegaye G, Wubie M, Endris M. Tuberculosis and Human Immune Deficiency Virus Co-infection in Debre Markos Referral Hospital in Northwest Ethiopia: A Five Years Retrospective Study. J AIDS Clin Res. 2013;4(263):2-4.
11. Malathi M, Vijayalakshmi A, Ramani C, Balapriya P, Kulothungan R. Prevalence of Tuberculosis and HIV co-infection with respect to CD4 counts in Chengalpattu Medical College and Hospital. BMC Infect Dis. 2014;14(Suppl 3): 24.
12. Goldfeld A, Ellner JJ. Pathogenesis and management of HIV/TB co-infection in Asia. Tuberculosis. 2007;87:26-30.
13. Brunello MEF, Chiaravalloti Neto F, Arcêncio RA, Andrade RLdP, Magnabosco GT, Villa TCS. Areas of vulnerability to HIV/TB co-infection in Southeastern Brazil. Rev Saude Publica. 2011; 45(3):556-63.
14.Mbow M, Santos NS, Camara M, Ba A, Niang A, Daneau G, et al. HIV and Tuberculosis coinfection impact T-cell activation markers but not the numbers subset of regulatory T-cells in HIV-1 infected patients: original research. Afr J Lab Med. 2013;2(1): 1-8.
15.Dibua U. Liaison of tuberculosis and human immunodeficiency virus (HIV) co-infection in the progression to AIDS: Prognostic value of cluster differentiation 4 (CD4+) cell as the marker of disease progression. Int J Med Med Sci.
2013;5(3):140-49.
16.Srivastav S. Socio-Demographic Profile of TBHIV Co-Infected Patients in Bundelkhand Region, Uttar-Pradesh. Natl J Med Res. 2012;2(2):149-51.
17.Dhungana G, Ghimire P, Sharma S, Rijal BP. Tuberculosis co-infection in HIV infected persons of Kathmandu. Nepal Med Coll J. 2008;10(2):96-99.
18. Tabatabaee H, Afsar-Kazerooni P, Alimohamadi Y, Hasanabadi A, Khavandegaran F, Tayeri K, et al. Intensified or Routine Case Finding for Patients: Which is Better?. J Health Sci Surveillance Sys. 2015;3(1):13-19.
19. Godfrey-Faussett P, Ayles H. "Can we control tuberculosis in high HIV prevalence settings?" Tuberculosis. 2003;83(1):68-76.
20. Rafiee S, Besharat S, Jabbari A, Golalipour F, Nasermoaadeli A. Epidemiology of tuberculosis in the northeast of Iran: a population-based study. Iran J Med Sci. 2009;34(3):193-97.
21.Yavari P. Epidemiology Textbook of prevalent disease in Iran. First edition, Tehran: Gap Publisher. 2014;131-147. [In Persian]
22. Mansoori D, Alaei K, Alaei A. Prevalence of clinical tuberculosis in HIV infected patients from Kermanshah Province, Iran. Tanaffos. 2002;1(2):27-33.
23. Pollock KM, Tam H, Grass L, Bowes S, Cooke GS, Pareek M, et al. Comparison of screening strategies to improve the diagnosis of latent tuberculosis infection in the HIV-positive population: a cohort study. BMJ Open. 2012; 2(2):1-7.
24. Shah S, Demissie M, Lambert L, Ahmed J, Leulseged S, Kebede T, et al. Intensified tuberculosis case finding among HIV-Infected persons from a voluntary counseling and testing center in Addis Ababa, Ethiopia. J Acquir
Immune Defic Syndr. 2009;50(5):537-45.
25. Moore D, Liechty C, Ekwaru P, Were W, Mwima G, Solberg P, et al. Prevalence, incidence andPulmonary Tuberculosis among HIV-Infected mortality associated with tuberculosis in HIVinfected patients initiating antiretroviral therapy in
rural Uganda. Aids. 2007;21(6):713-19.
26. Christopher CA, Kesieme E, Vivien OA. The pattern of presentation and prevalence of tuberculosis in HIV seropositive patients seen at Benin city, Nigeria. ISRN Pulmonol. 2012;1-6.
27.Sharma SK, Soneja M, Prasad K, Ranjan S. Clinical profile & predictors of poor outcome of adult HIV-tuberculosis patients in a tertiary care centre in north India. Indian J Med Res. 2014;139(1):154-60.
28. Rabirad N, Nejad EM, Hadizadeh MR, Begjan J, Ehsani SR. The prevalence of Tb in HIV patients and risk factor with frequent referral (Iran, 2009-10). Iran Red Crescent Med J. 2013;15(1):58-61.
29.Simsek H, Alpar S, Ucar N, Aksu F, Ceyhan I, Gözalan A, et al. comparison of tuberculosis skin testing T-spot.TB for diagnosis of latent and active tuberculosis. Jpn J Infect Dis. 2010;63:99-102.
30.Muyoyeta M , Maduskar P , Moyo M, Kasese N, Milimo D, Spooner R, et al. The sensitivity and specificity of using a computer-aided diagnosis program for automatically scoring chest X-rays of presumptive TB patients compared with Xpert MTB/RIF in Lusaka Zambia. PloS One. 2014;9(4): 1-9.
2. Prabakaran JJ, Alagusundaram M, Malar HV. Pulmonary Tuberculosis co-infection among HIV infected persons in and around District of Erode, Tamil Nadu, India. Int J Curr Microbiol App Sci. 2013;2(5):1-7.
3. Podlekareva DN, Mocroft A, Post FA, Riekstina V, Miro JM, Furrer H. Mortality from HIV and TB coinfections is higher in Eastern Europe than in Western Europe and Argentina. AIDS (London, England). 2009;23(18):2485-95.
4. Bhatt NB, Baudin E, Meggi B, da Silva C, Barrail-Tran A, Furlan V, et al. Nevirapine or efavirenz for tuberculosis and HIV coinfected patients: exposure and virological failure relationship. J Antimicrob Chemother. 2014;348:1-8.
5.Tursynbayeva T, Idrissova M, Markabaeva T, Usenova G, Utepkaliyeva G, Akhmetova G, et al. Improving Surveillance on Tuberculosis and HIV Co-Infection in Kazakhstan. Open Infect Dis J. 2013;7(1):54-58.
6. Siawaya JFD, Ruhwald M, Eugen-Olsen J, Walzl G. Correlates for disease progression and prognosis during concurrent HIV/TB infection. Int Infect Dis. 2007;11(4):289-99.
7. Metcalfe JZ, Porco TC, Westenhouse J, Damesyn M, Facer M, Hill J, Xia Q, et al. Tuberculosis and HIV co-infection, California, USA, 1993–2008. Emerg Infect Dis. 2013;19(3):400-6.
8. Pawlowski A, Jansson M, Scold M, Rottenberg ME, Kallenius G. Tuberculosis and HIV coinfection. PLoS Pathogens. 2012;8(2): 1-7.
9. Pontali E, Pasticci M, Matteelli A, Baldelli F, Migliori GB. Tuberculosis and HIV co-infection: do we have a surveillance system in Europe? Eur Respir J. 2011;38(6):1258-60.
10. Esmael A, Tsegaye G, Wubie M, Endris M. Tuberculosis and Human Immune Deficiency Virus Co-infection in Debre Markos Referral Hospital in Northwest Ethiopia: A Five Years Retrospective Study. J AIDS Clin Res. 2013;4(263):2-4.
11. Malathi M, Vijayalakshmi A, Ramani C, Balapriya P, Kulothungan R. Prevalence of Tuberculosis and HIV co-infection with respect to CD4 counts in Chengalpattu Medical College and Hospital. BMC Infect Dis. 2014;14(Suppl 3): 24.
12. Goldfeld A, Ellner JJ. Pathogenesis and management of HIV/TB co-infection in Asia. Tuberculosis. 2007;87:26-30.
13. Brunello MEF, Chiaravalloti Neto F, Arcêncio RA, Andrade RLdP, Magnabosco GT, Villa TCS. Areas of vulnerability to HIV/TB co-infection in Southeastern Brazil. Rev Saude Publica. 2011; 45(3):556-63.
14.Mbow M, Santos NS, Camara M, Ba A, Niang A, Daneau G, et al. HIV and Tuberculosis coinfection impact T-cell activation markers but not the numbers subset of regulatory T-cells in HIV-1 infected patients: original research. Afr J Lab Med. 2013;2(1): 1-8.
15.Dibua U. Liaison of tuberculosis and human immunodeficiency virus (HIV) co-infection in the progression to AIDS: Prognostic value of cluster differentiation 4 (CD4+) cell as the marker of disease progression. Int J Med Med Sci.
2013;5(3):140-49.
16.Srivastav S. Socio-Demographic Profile of TBHIV Co-Infected Patients in Bundelkhand Region, Uttar-Pradesh. Natl J Med Res. 2012;2(2):149-51.
17.Dhungana G, Ghimire P, Sharma S, Rijal BP. Tuberculosis co-infection in HIV infected persons of Kathmandu. Nepal Med Coll J. 2008;10(2):96-99.
18. Tabatabaee H, Afsar-Kazerooni P, Alimohamadi Y, Hasanabadi A, Khavandegaran F, Tayeri K, et al. Intensified or Routine Case Finding for Patients: Which is Better?. J Health Sci Surveillance Sys. 2015;3(1):13-19.
19. Godfrey-Faussett P, Ayles H. "Can we control tuberculosis in high HIV prevalence settings?" Tuberculosis. 2003;83(1):68-76.
20. Rafiee S, Besharat S, Jabbari A, Golalipour F, Nasermoaadeli A. Epidemiology of tuberculosis in the northeast of Iran: a population-based study. Iran J Med Sci. 2009;34(3):193-97.
21.Yavari P. Epidemiology Textbook of prevalent disease in Iran. First edition, Tehran: Gap Publisher. 2014;131-147. [In Persian]
22. Mansoori D, Alaei K, Alaei A. Prevalence of clinical tuberculosis in HIV infected patients from Kermanshah Province, Iran. Tanaffos. 2002;1(2):27-33.
23. Pollock KM, Tam H, Grass L, Bowes S, Cooke GS, Pareek M, et al. Comparison of screening strategies to improve the diagnosis of latent tuberculosis infection in the HIV-positive population: a cohort study. BMJ Open. 2012; 2(2):1-7.
24. Shah S, Demissie M, Lambert L, Ahmed J, Leulseged S, Kebede T, et al. Intensified tuberculosis case finding among HIV-Infected persons from a voluntary counseling and testing center in Addis Ababa, Ethiopia. J Acquir
Immune Defic Syndr. 2009;50(5):537-45.
25. Moore D, Liechty C, Ekwaru P, Were W, Mwima G, Solberg P, et al. Prevalence, incidence andPulmonary Tuberculosis among HIV-Infected mortality associated with tuberculosis in HIVinfected patients initiating antiretroviral therapy in
rural Uganda. Aids. 2007;21(6):713-19.
26. Christopher CA, Kesieme E, Vivien OA. The pattern of presentation and prevalence of tuberculosis in HIV seropositive patients seen at Benin city, Nigeria. ISRN Pulmonol. 2012;1-6.
27.Sharma SK, Soneja M, Prasad K, Ranjan S. Clinical profile & predictors of poor outcome of adult HIV-tuberculosis patients in a tertiary care centre in north India. Indian J Med Res. 2014;139(1):154-60.
28. Rabirad N, Nejad EM, Hadizadeh MR, Begjan J, Ehsani SR. The prevalence of Tb in HIV patients and risk factor with frequent referral (Iran, 2009-10). Iran Red Crescent Med J. 2013;15(1):58-61.
29.Simsek H, Alpar S, Ucar N, Aksu F, Ceyhan I, Gözalan A, et al. comparison of tuberculosis skin testing T-spot.TB for diagnosis of latent and active tuberculosis. Jpn J Infect Dis. 2010;63:99-102.
30.Muyoyeta M , Maduskar P , Moyo M, Kasese N, Milimo D, Spooner R, et al. The sensitivity and specificity of using a computer-aided diagnosis program for automatically scoring chest X-rays of presumptive TB patients compared with Xpert MTB/RIF in Lusaka Zambia. PloS One. 2014;9(4): 1-9.
| Files | ||
| Issue | Vol 4 No 2 (2018) | |
| Section | Original Article(s) | |
| Keywords | ||
| co-infection HIV/AIDS sputum culture sputum smear Tuberculosis | ||
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How to Cite
1.
Alimohamadi Y, Afsar-kazerooni P, Sepandi M, Chaichian S, Tabatabaee H, Kashi Z, Alimohammadi M, Esmaeilzadeh F. Evaluation of sensitivity and specificity of tuberculosis diagnostic tools among HIV positive patients: A cross-sectional study. JBE. 2018;4(2):113-118.
