Tuberculosis in HIV voluntary counselling and testing centres in Dar es Salaam, Tanzania

Abstract

The human immunodeficiency virus (HIV) has contributed to an increase in tuberculosis (TB) worldwide. HIV voluntary counselling and testing (VCT) centres are cost-effective for HIV screening. Therefore there is a potential of tapping into the success of VCT centres by incorporating TB screening. The aim of this study was to determine the extent of TB and TB/HIV co-infection among VCT centre attendees. We enrolled 1318 consecutive subjects from 2 VCT centres in Dar es Salaam. The diagnosis of TB was based on evidence of Mycobacterium tuberculosis in sputum or tissue aspirates following microscopy or culture. In the absence of M. tuberculosis, the presence of 2 of the following was considered: clinical features of TB, suggestive chest radiographs and response to anti-tuberculosis trial therapy. HIV was diagnosed in 347 (26%) subjects. TB was present in 101 (7.7%) subjects of whom 63 (62%) were diagnosed at VCT centres and 38 (38%) were known TB cases who came for HIV testing. Pulmonary TB (PTB) was detected in 52 (83%) subjects. The diagnosis of PTB was based on sputum culture in 35 (67%), sputum microscopy in 20 (38%), and clinical and radiological findings in 17 (33%) subjects. TB/HIV co-infection was detected in 70 (5.3%) subjects. PTB was common in stand-alone VCT centres. Therefore VCT centres could serve as an entry point for TB screening.

Acknowledgements

We thank the Tanzania Ministry of Health for financial assistance. We would like to acknowledge and thank all the study participants. We also thank Mr P. Ngowi and Mr E. Shogolo from the National TB and Leprosy Reference Laboratory; Dr E. Mgaya from the Department of Pathology, Muhimbili National Hospital (MNH) for assistance with sample processing; Dr R. Kazema and Dr Lyimo from the Department of Radiology (MNH) for assistance with radiological interpretation; Dr J. Mbwambo and Dr N. Hogan from MHIC and all the staff of the 2 VCT centres; Mr C. Makwaya and Dr C. Moshiro from Muhimbili University of Health and Allied Sciences (MUHAS) for assistance with the statistical analysis; and Dr L. Mwakalukwa for assistance with data acquisition.

Declaration of interest: The authors declare that they have no competing interests.