HIV Prevalence Among Persons Suspected of Tuberculosis

Naik, Balaji; Mv, Ajay Kumar; Lal, Kumaraswamy; Doddamani, Sangamesh; Krishnappa, M; Inamdar, Vikas; Satyanarayana, Srinath; Gupta, Devesh; Dewan, Puneet

doi:10.1097/qai.0b013e318245c9df

Cited by 13 publications

(14 citation statements)

References 5 publications

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“…The specifi c objectives of the study were to assess, among a cohort of TB patients: 1) the feasibility of screening for DM, 2) the prevalence of DM, 3) the demographic and clinical features associated with DM, and 4) the number needed to screen (NNS) to fi nd one new case of DM among TB patients. 13,14 …”

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confidence: 99%

Screening tuberculosis patients for diabetes in a tribal area in South India

Achanta

Tekumalla

Jaju

et al. 2013

public health action

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Setting:Ten peripheral health institutions of a tribal t uberculosis unit, Saluru, Vizianagaram District, South India. Objective: To assess among tuberculosis (TB) patients: 1) the feasibility of screening for diabetes mellitus (DM), 2) the prevalence of DM, 3) the demographic and clinical features associated with DM, and 4) the number needed to screen (NNS) to find one new case of DM. Design: Cross-sectional study: all TB patients registered from January to September 2012 were screened for DM using a screening questionnaire and random blood glucose, followed by fasting blood glucose (FBG) measurements using a glucometer. DM was diagnosed if FBG was ⩾126 mg/dl. Results: Of 381 patients, 374 (98%) were assessed for DM, suggesting feasibility of screening, and 19 (5%) were found to have DM (12 were newly diagnosed and 7 had a previous diagnosis of DM). The only characteristic associated with DM was age ⩾40 years. The NNS to detect a new case of DM among all TB patients was 31; among those aged ⩾40 years, the NNS was 20, and among current smokers it was 21. Conclusion: Screening of TB patients for DM was feasible and effective, and this should inform national scaleup. Other key considerations include the continued provision of free TB-DM screening, with co-location and integration of services. showed that of 8109 TB patients who were assessed for DM, 1084 (13%) were found to have DM, based on fasting blood glucose (FBG) measurements. Based on these data, a policy decision was made by India's Revised National TB Control Programme (RNTCP) to implement countrywide screening of TB patients for DM. 11 One limitation of this study, however, was that it published only aggregate data from all sites, and may have missed site-specifi c variations, and other socio-demographic and clinical factors affecting the effectiveness and feasibility of the screening programme. AFFILIATIONSWe therefore analysed individual patient data and described the effectiveness of screening all TB patients for DM in one tribal TU. The tribal area is remote and diffi cult to access due to poor connectivity and lack of other basic infrastructure. Indicators relating to literacy, economic status, social status and access to health care services are poor among tribes compared to the general population. 12 The tribes are in transition from a forest-centred way of life to a rural, settled farming lifestyle. Given the different lifestyle, more access to unprocessed, fi brerich foods, including fruit and vegetables in their diet and greater daily physical activity, we hypothesized that the prevalence of DM would be considerably lower in tribal areas when compared with the rest of the country. The specifi c objectives of the study were to assess, among a cohort of TB patients: 1) the feasibility of screening for DM, 2) the prevalence of DM, 3) the demographic and clinical features associated with DM, and 4) the number needed to screen (NNS) to fi nd one new case of DM among TB patients. 13,14 METHODS Study designThis was a descriptive study of all TB patie...

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confidence: 99%

Screening tuberculosis patients for diabetes in a tribal area in South India

Achanta

Tekumalla

Jaju

et al. 2013

public health action

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“…In the light of the strong evidence supporting this, 6,7 the national TB and HIV programmes in India took a joint policy decision to implement PITC among patients with presumptive TB in high HIV settings (HIV prevalence ⩾1% among pregnant women and ⩾5% among high-risk groups)-namely the states of Karnataka, Andhra Pradesh, Tamil Nadu, Maharashtra, Manipur and Nagaland-and further recommended that similar surveillance efforts be conducted in moderate and low HIV burden settings (HIV prevalence <1% among pregnant women and/or <5% among high-risk groups) to inform national policy decision. 8 To address the knowledge gap, we undertook a study with the aim of assessing HIV testing uptake and HIV positivity among presumptive TB patients in Puducherry, a low HIV prevalence district in South India.…”

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confidence: 99%

Uptake of HIV testing and HIV positivity among presumptive tuberculosis patients at Puducherry, South India

Chinnakali

Kumar²,

Mahalakshmi

et al. 2013

public health action

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“…What proportion of TB patients would have been additionally diagnosed to have Diabetes Mellitus, if all TB patients are actively screened for DM?Yes [36]2. What is the HIV Sero-prevalence among TB suspects (aged 18 years or more) examined for diagnostic smear microscopy at Designated Microscopy Centres (DMCs) of Mandya district, South India?Yes [30]3. What is the HIV Sero-prevalence among TB suspects (aged 18 years or more) examined for diagnostic smear microscopy at Designated Microscopy Centres in Vizianagaram district, South India?Yes [31]4.…”

Section: Implementation Of Operational Research Training Coursesmentioning

confidence: 99%

“…Studies conducted in Karnataka and Andhra Pradesh showed that HIV testing amongst presumptive TB patients substantially increased the proportion of HIV-positive persons [30,31]. Prior to these studies, HIV counselling and testing of all presumptive TB patients was not a policy in India, despite international recommendations.…”

Section: Contribution Of or To Policy And Practicementioning

confidence: 99%

Operational research within a Global Fund supported tuberculosis project in India: why, how and its contribution towards change in policy and practice

Sagili¹,

Satyanarayana

Chadha³

et al. 2018

Global Health Action

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Background: The Global Fund encourages operational research (OR) in all its grants; however very few reports describe this aspect. In India, Project Axshya was supported by a Global Fund grant to improve the reach and visibility of the government Tuberculosis (TB) services among marginalised and vulnerable communities. OR was incorporated to build research capacity of professionals working with the national TB programme and to generate evidence to inform policies and practices. Objectives: To describe how Project Axshya facilitated building OR capacity within the country, helped in addressing several TB control priority research questions, documented project activities and their outcomes, and influenced policy and practice. Methods: From September 2010 to September 2016, three key OR-related activities were implemented. First, practical output-oriented modular training courses were conducted (n = 3) to build research capacity of personnel involved in the TB programme, co-facilitated by The Union, in collaboration with the national TB programme, WHO country office and CDC, Atlanta. Second, two large-scale Knowledge, Attitude and Practice (KAP) surveys were conducted at baseline and mid-project to assess the changes pertaining to TB knowledge, attitudes and practices among the general population, TB patients and health care providers over the project period. Third, studies were conducted to describe the project’s core activities and outcomes. Results: In the training courses, 44 participant teams were supported to develop research protocols on topics of national priority, resulting in 28 peer-reviewed scientific publications. The KAP surveys and description of project activities resulted in 14 peer-reviewed publications. Of the published papers at least 12 have influenced change in policy or practice. Conclusions: OR within a Global Fund supported TB project has resulted in building OR capacity, facilitating research in areas of national priority and influencing policy and practice. We believe this experience will provide guidance for undertaking OR in Global Fund projects.

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HIV Prevalence Among Persons Suspected of Tuberculosis

Cited by 13 publications

References 5 publications

Screening tuberculosis patients for diabetes in a tribal area in South India

Screening tuberculosis patients for diabetes in a tribal area in South India

Uptake of HIV testing and HIV positivity among presumptive tuberculosis patients at Puducherry, South India

Operational research within a Global Fund supported tuberculosis project in India: why, how and its contribution towards change in policy and practice

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