AEGiS-13IAC: Screening for active tuberculosis prior to tuberculosis preventive therapy among HIV-infected gold miners in South Africa.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

Screening for active tuberculosis prior to tuberculosis preventive therapy among HIV-infected gold miners in South Africa.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. MoOrC188)

Day JH, Grant AD, Charalambous S, Moloi V, Roux S, Piorkowski A, Nhiwatiwa R, Hayes RJ, Churchyard GJ
J.H. Day, Aurum Health Research, PO Box 87, Welkom, 9460, South Africa, Tel.: +27 57 900 4398, Fax: +27 57 900 4568, E-mail: jday@aghs.co.za

BACKGROUND: The objective of this study was to determine the usefulness of symptom screening and simple investigations in identifying active tuberculosis (TB) prior to starting TB preventive therapy among HIV-infected gold miners in South Africa.

METHODS: HIV-infected mineworkers were screened for active TB, on a voluntary basis, with a symptom questionnaire, clinical examination, chest radiograph and fluorochrome microscopy and culture of two sputum samples. PPD skin-testing was not performed. Active pulmonary TB was defined as M. tuberculosis on sputum culture. A comprehensive TB control programme is in place, including annual radiological screening.

RESULTS: To date 195 miners have been screened for active tuberculosis. 5 individuals (2.6%) have been found to have active TB. Preliminary results are presented. For each criterion, the sensitivity, specificity, positive predictive value and negative predictive value were, respectively: new cough: 20%, 85.3%, 3.5%, 97.6%; new sputum production: 20%, 86.9%, 3.8%, 97.6%; weight loss: 40%, 94.2%, 15.4%, 98.4%; new CXR change: 40%, 92.6%, 12.5%, 98.3%, sputum AFB positive: 40%, 98.4%, 40%, 98.4%.

CONCLUSION: These preliminary data suggest that the prevalence of active TB in this population is low. Clinical criteria may be less useful than sputum microscopy in detecting active TB. These findings should be compared with those in other populations.

Keywords: AEGIS, Tuberculosis, HIV Infections, Tuberculosis, Pulmonary, Gold, Mycobacterium tuberculosis, Mining, Sputum, Tuberculin Test, HIV Seropositivity, Mass Screening, CD4 Lymphocyte Count, South Africa, Mass Chest X-Ray, prevention & control, diagnosis, radiography
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MoOrC188