The evaluation of different strategies to improve the diagnosis of tuberculosis in people living with HIV in resource-limited settings
type: CreativeWork
description: Background The 2019 WHO screening and diagnostic algorithm for tuberculosis in people living with HIV (PLHIV) has 2 components: the WHO Xpert MTB/RIF (Xpert) algorithm and WHO Alere Determine TB-LAM (AlereLAM) algorithm. According to the WHO Xpert algorithm, WHO recommends that PLHIV be routinely screened for tuberculosis with the WHO foursymptom screen (W4SS; comprising any one of current cough, fever, night sweats, or weight loss) and, if the screen is positive, receive Xpert or Xpert MTB/RIF Ultra (Xpert Ultra) confirmatory testing. According to the WHO AlereLAM algorithm, WHO also recommends that PLHIV be routinely screened for tuberculosis using screening criteria and, if the screen is positive, receive urine lateral-flow lipoarabinomannan (LF-LAM) confirmatory testing with AlereLAM. We aimed: i. To determine the diagnostic accuracy of the W4SS and alternative screening tools and strategies in ambulatory PLHIV, including key subgroups, and to compare the diagnostic accuracy of the WHO Xpert algorithm with Xpert confirmatory testing for all ambulatory PLHIV ii. To determine the performance of the W4SS and alternative screening tools and strategies in HIV-positive inpatients and to compare the diagnostic accuracy of the WHO Xpert algorithm with Xpert confirmatory testing for all HIV-positive inpatients iii. To determine the performance of WHO screening criteria and alternative screening tools and strategies to guide LF-LAM testing in HIV-positive inpatients and to compare the performance of the WHO AlereLAM algorithm with AlereLAM and Fujifilm SILVAMP TB-LAM (FujiLAM; a novel LF-LAM test) confirmatory testing in all HIV-positive inpatients. iv. To develop and validate novel clinical prediction models (CPMs) for tuberculosis screening in outpatient PLHIV and to determine the clinical utility of these CPMs and WHO-recommended screening tools Methods We conducted a systematic review and individual participant data (IPD) meta-analysis. We updated a search of PubMed (…
abstract: Background The 2019 WHO screening and diagnostic algorithm for tuberculosis in people living with HIV (PLHIV) has 2 components: the WHO Xpert MTB/RIF (Xpert) algorithm and WHO Alere Determine TB-LAM (AlereLAM) algorithm. According to the WHO Xpert algorithm, WHO recommends that PLHIV be routinely screened for tuberculosis with the WHO foursymptom screen (W4SS; comprising any one of current cough, fever, night sweats, or weight loss) and, if the screen is positive, receive Xpert or Xpert MTB/RIF Ultra (Xpert Ultra) confirmatory testing. According to the WHO AlereLAM algorithm, WHO also recommends that PLHIV be routinely screened for tuberculosis using screening criteria and, if the screen is positive, receive urine lateral-flow lipoarabinomannan (LF-LAM) confirmatory testing with AlereLAM. We aimed: i. To determine the diagnostic accuracy of the W4SS and alternative screening tools and strategies in ambulatory PLHIV, including key subgroups, and to compare the diagnostic accuracy of the WHO Xpert algorithm with Xpert confirmatory testing for all ambulatory PLHIV ii. To determine the performance of the W4SS and alternative screening tools and strategies in HIV-positive inpatients and to compare the diagnostic accuracy of the WHO Xpert algorithm with Xpert confirmatory testing for all HIV-positive inpatients iii. To determine the performance of WHO screening criteria and alternative screening tools and strategies to guide LF-LAM testing in HIV-positive inpatients and to compare the performance of the WHO AlereLAM algorithm with AlereLAM and Fujifilm SILVAMP TB-LAM (FujiLAM; a novel LF-LAM test) confirmatory testing in all HIV-positive inpatients. iv. To develop and validate novel clinical prediction models (CPMs) for tuberculosis screening in outpatient PLHIV and to determine the clinical utility of these CPMs and WHO-recommended screening tools Methods We conducted a systematic review and individual participant data (IPD) meta-analysis. We updated a search of PubMed (…
author: Dhana, Ashar Vijay
keywords: medicine
date published: 2023
date modified: 2026-07-24T01:33:54Z
provider: University of Cape Town
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Department of Medicine

PropertyValue
property ID: Handle
value: http://hdl.handle.net/11427/37929