Outcome of tuberculosis treatment in HIV-positive adults diagnosed through active versus passive case-finding

Figures & data

Table 1 Comparison of baseline characteristics, signs, and symptoms stratified by tuberculosis case-finding

Categories	Variables	Description	ACF^a TB cases (n=132; %)	PCF^b TB cases (n=307; %)	p
Total cohort (%)	–	–	132 (30.1)	307 (69.9)	–
Baseline characteristics	Gender	Male	68 (51.5)	156 (50.8)	0.917
		Female	64 (48.5)	151 (49.2)
	Age (years)	Median age	35 (28–44^c)	32 (28–40^c)	0.120
	Residence	Urban	101 (78.3)	274 (89.5)	0.03
		Rural	28 (21.7)	32 (10.5)
	CD4 count (cells/mm^3)	Median	169 (91–271^c)^d	173 (95–336^a)	0.160
	Hemoglobin (g/dL)	Median	10.4 (9.1–11.9^c)	10.7 (9.3–12.0^c)	0.289
	Type of TB	Pulmonary	128 (97.0%)	224 (73.0)	<0.001
		Extrapulmonary	4 (3.0%)	83 (27.0)
	Pulmonary TB smear status	Positive	27 (21.1)	99 (44.2)	<0.001
		Negative	101 (78.9)	125 (55.8)
WHO symptoms	WHO symptom screen^e	Positive	121 (92.4)	292 (95.7)	0.164
		Negative	10 (7.6)	13 (4.3)
	Fever	Yes	86 (65.6)	307 (82.4)	<0.001
		No	37 (34.4)	54 (17.6)
	Night sweats	Yes	95 (72.0)	256 (83.4)	<0.01
		No	40 (28.0)	51 (16.6)
	Weight loss	Yes	109 (82.6)	254 (83.0)	0.891
		No	23 (17.4)	52 (17.0)
	Cough	Yes	82 (62.1)	190 (62.1)	1.0
		No	50 (37.9)	116 (37.9)
Other symptoms	Loss of appetite	Yes	85 (64.4)	249 (81.1)	<0.001
		No	47 (35.6)	58 (18.9)
	Blood stained sputum	Yes	6 (4.5)	47 (15.4)	0.001
		No	126 (95.5)	258 (84.6)
	Bed ridden	Yes	13 (9.9)	81 (26.4)	<0.001
		No	118 (90.1)	226 (73.6)
Physical findings	Conjunctival pallor	Yes	34 (26.0)	118 (38.4)	0.012
		No	97 (74.0)	189 (61.6)
	Peripheral lymphadenopathy	Yes	14 (10.6)	58 (19.0)	0.035
		No	118 (89.4)	248 (81.0)
Biometric data	BMI^f (kg/m^2)	Median	17.8 (16.2–19.7^c)	17.5 (16.0–19.5^c)	0.342
	MUAC^g (cms)	Median	21.0 (19.0–23.0^c)	20.0 (19.0–22.0^c)	0.033

^aACF: active case-finding; TB case detected through intensified screening regardless of symptoms.

^bPCF: passive case-finding; TB case detected after a symptomatic patient came to a health facility.

^cInterquartile range.

^dCD4≤350 cells/mm³ inclusion criteria for ACF.

^eWHO symptom screen positive: presence of current cough, fever, night sweats or weight loss.

^fBMI: body mass index.

^gMUAC: mid upper-arm circumference.

Table 2 Comparison of treatment outcomes between TB cases detected through active and passive case-finding

TB treatment outcome	ACF^a TB cases	PCF^b TB cases	p ^c
Total cohort	132	307	–
Cured or completed treatment, n (%)	102 (77.2)	247 (80.5)	0.223
Lost to follow-up, n (%)	12 (9.1)	20 (6.5)
Died, n (%)	10 (7.6)	17 (5.5)
Transfer of care, n (%)	8 (6.1)	23 (7.5)	–

^aACF: active case-finding; TB case detected through intensified screening regardless of symptoms.

^bPCF: passive case-finding; TB case detected after a symptomatic patient came to a health facility.

^cCured or completed treatment versus loss to follow-up or death.

Table 3 Characteristics of TB cases detected through active and passive case-finding stratified by treatment outcomes

		ACF cohort^a			PCF cohort^b
Patient characteristics	Variables	TS^c (%)	AO^d (%)	p	TS (%)	AO (%)	p
Gender	Male	54 (52.9)	10 (51.9)	0.639	124 (50.0)	22 (53.7)	0.737
	Female	48 (47.1)	12 (48.1)		124 (50.0)	19 (46.3)
Age (years)	Median age	36 (28–45^e)	30 (28–36^e)	0.225	33 (28–40^e)	30 (27–40^e)	0.659
Residence^f	Urban	79 (79.0)	15 (71.4)	0.564	223 (89.9)	35 (87.5)	0.584
	Rural	21 (21.0)	6 (28.6)		25 (10.1)	5 (12.5)
CD4 count (cells/mm^3)	Median CD4 count	170 (98–278^e)	102 (77–260^e)	0.379	178 (105–344^e)	173 (70–320^e)	0.598
CD4 cell strata (cells/mm^3)	>200	38 (37.3)	9 (40.9)	0.023	113 (46.4)	17 (41.5)	0.227
	101–200	37 (36.3)	2 (9.1)		73 (29.4)	9 (22.0)
	≤100	27 (26.5)	11 (50.0)		60 (24.2)	15 (36.6)
Hemoglobin (g/dL)	Median hemoglobin	10.5 (9.3–12.0^e)	9.7 (8.4–11.0^e)	0.147	10.7 (9.3–12.0^e)	11.2 (9.7–12.2^e)	0.444
Type of TB	Pulmonary	99 (97.1)	21 (95.5)	0.547	179 (72.2)	33 (80.5)	0.341
	Extrapulmonary	3 (2.9)	1 (4.5)		69 (27.8)	8 (19.5)
Smear status	Positive	18 (18.2)	7 (33.3)	0.142	79 (44.1)	15 (45.5)	1.0
	Negative	81 (81.8)	14 (66.7)		100 (55.9)	118 (54.5)
BMI (kg/m^2)	Median BMI	17.8 (16.5–19.8^e)	16.3 (14.8–19.0^e)	0.036	17.6 (16.2–19.6^e)	16.9 (15.3–18.1^e)	0.015
MUAC (cms)	Median MUAC	21.5 (19.0–23.0^e)	20.0 (18.5–22.0^e)	0.042	21.0 (19.0–23.0^e)	19.0 (18.0–21.0^e)	0.001
WHO symptom screen	Positive	92 (91.1)	21 (95.5)	0.689	233 (94.7)	41 (100)	0.226
	Negative	9 (8.9)	1 (4.5)		13 (5.3)	0 (0)

^aACF: active case-finding; TB case detected through intensified screening regardless of symptoms.

^bPCF: passive case-finding; TB case detected after a symptomatic patient came to a health facility

^cTS: treatment success which includes TB patients who were cured or completed treatment.

^dAO: adverse TB treatment outcome which includes loss to follow-up or death.

^eInterquartile range.

^fResidence: missing in 11 study participants in the ACF cohort.