ABSTRACT
SETTING: A DOTS clinic in an academic tertiary referral hospital in South India. OBJECTIVE: To evaluate the performance of two rapid enzyme-linked immunoassays (EIAs) for the detection of human immunodeficiency virus (HIV) infection in sputum samples of patients with tuberculosis (TB). DESIGN: We prospectively recruited 522 consecutive out-patients presenting to the DOTS clinic with confirmed TB of any type to undergo HIV testing using reference serum EIA and index-blinded parallel sputum HIV testing with two rapid EIAs designed for oral mucosal transudate. RESULTS: HIV positivity was 14.9% (95%CI 12.1-18.4). Compared to reference serum EIA, the Oraquick™ assay was 93.1% sensitive (95%CI 83.8-97.4) and 95.3% specific (95%CI 92.7-96.9), while the Aware™ assay was 92.3% sensitive (95%CI 83.4-96.8) and 96.6% specific (95%CI 94.4-98.0). The positive predictive values were respectively 77.0% and 82.7%. After freezing of sputum, the sensitivity of both assays declined, but the specificity significantly increased. Higher sputum volume reduced the odds of obtaining a true result with both assays. CONCLUSION: HIV testing of fresh sputum is not sufficiently accurate for anonymous HIV surveillance among TB patients in a setting of low (<10%) HIV prevalence. Freezing sputum samples and limiting sputum volume for HIV testing may improve assay specificity.
Subject(s)
HIV Infections/diagnosis , HIV/isolation & purification , Mass Screening , Mycobacterium tuberculosis/isolation & purification , Sputum/microbiology , Sputum/virology , Tuberculosis/diagnosis , Adult , Female , HIV Infections/epidemiology , HIV Infections/virology , Humans , Immunoenzyme Techniques , India/epidemiology , Logistic Models , Male , Mass Screening/methods , Middle Aged , Predictive Value of Tests , Prevalence , Prospective Studies , Reagent Kits, Diagnostic , Sensitivity and Specificity , Specimen Handling , Tuberculosis/epidemiology , Tuberculosis/microbiologyABSTRACT
A study on morbity pattern and time trends of filaria cases was carried out in a PHC of Dakshin Kannada District during November 2000 to January 2001. The age and sex distribution of all 416 filaria cases recorded revealed that 235 (56.49%) were females and maximum concentration of 263 (63.21%) was in the age group of 16-45 years. The seasonal distribution revealed that rainy season accounted the highest number of cases 197 (47.35%). The prevalence was highest, 1.96/1000 population in the year 1993 and lowest, 0.71/1000 population in the year 1995.
