Tuberculosis case finding and detection of drug resistance among hiv-infected patients

This delays diagnosis and may lead to transmission within the community.

World Health Organisation (WHO) recommends routine screening for active TB disease among patients living with HIV, with treatment for active TB or isoniazid preventive therapy for latent TB. However, due to resource limited settings, only a few individuals have been screened for TB. Moreover, the emergence of Multidrug resistance (MDR) is also a limiting factor in combating TB. Drug resistant TB exists in areas with high risk of infection with HIV. MDR-TB has progressed to extensively-drug resistant status (XDR-TB) and totally drug resistant (TDR-TB) infections in some areas. Other factors that contribute to development of active TB in HIV-positive patients include the degree of immunosuppression, lifestyle, high risk behaviour, and TB contact history.

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This paper is a critical analysis of a study done at Gondar, Northwest Ethiopia by Alemayehu, et al., (2014). The main hypothesis of the study was to establish the prevalence of undiagnosed pulmonary tuberculosis cases through active case finding and including multi-drug resistant TB (MDR-TB) among HIV-infected patients. The other hypothesis was to determine the causative agent for tuberculosis in the study population. The study area was appropriate because Ethiopia is ranked among top among countries with high burden of TB incidence. It has also a high prevalence rate of newly diagnosis and retreatment cases. Two XDR-TB cases were reported from a total of 45 MDR-TB cases in a study done at St. Peter’s TB Specialised Hospital and Nutrition Research Institute. In HIV positive patients, diagnosis is difficult because of lack of cavitary lesions in the advanced stages which cause a paucibacillary state in sputum.

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