TABLE 3.
SENSITIVITY AND SPECIFICITY OF SYMPTOMS AND INVESTIGATIONS AT SCREENING FOR ACTIVE CASE FINDING OF PULMONARY TUBERCULOSIS, BY HIV STATUS
| Sensitivity (95% CI) |
Specificity (95% CI) |
|||||
|---|---|---|---|---|---|---|
| Screening Method | HIV-uninfected (N = 31) | HIV-infected (N = 20) | P Value | HIV-uninfected (N = 1347) | HIV-infected (N = 544) | P Value |
| Symptom | ||||||
| New or worsening cough | ||||||
| Any duration | 16.1 (5.5–33.7) | 15.0 (3.2–37.9) | >0.999 | 98.6 (97.8–99.1) | 97.1 (95.3–98.3) | 0.036 |
| >2 wk | 9.7 (2.0–25.8) | 5.0 (0.1–24.9) | >0.999 | 99.3 (98.7–99.7) | 98.5 (97.1–99.4) | 0.108 |
| >3 wk | 6.5 (0.8–21.4) | 5.0 (0.1–24.9) | >0.999 | 99.5 (98.9–99.8) | 98.5 (97.1–99.4) | 0.045 |
| New or worsening sputum production | 16.1 (5.5–33.7) | 0.0 (0.0–16.8) | 0.143 | 99.5 (98.9–99.8) | 97.6 (95.9–98.7) | 0.001 |
| Hemoptysis | 6.5 (0.8–21.4) | 0.0 (0.0–16.8) | 0.514 | 99.3 (98.7–99.7) | 99.4 (98.4–99.9) | 1 |
| Night sweats | 25.8 (11.9–44.6) | 25.0 (8.7–49.1) | >0.999 | 95.6 (94.4–96.6) | 92.1 (89.5–94.2) | 0.003 |
| Fever | ||||||
| Any duration | 6.5 (0.8–21.4) | 0.0 (0.0–16.8) | 0.514 | 99 (98.3–99.4) | 98.3 (96.9–99.2) | 0.257 |
| >2 wk | 6.5 (0.8–21.4) | 0.0 (0.0–16.8) | 0.514 | 99.7 (99.2–99.9) | 99.3 (98.1–99.8) | 0.238 |
| >3 wk | 6.5 (0.8–21.4) | 0.0 (0.0–16.8) | 0.514 | 99.7 (99.2–99.9) | 99.3 (98.1–99.8) | 0.238 |
| Weight loss >5kg | 19.4 (7.5–37.5) | 10.0 (1.2–31.7) | 0.456 | 95.9 (94.7–96.9) | 93.6 (91.2–95.5) | 0.032 |
| ≥1 symptom | 29 (14.2–48.0) | 30.0 (11.9–54.3) | >0.999 | 91.3 (89.7–92.8) | 87.9 (84.8–90.5) | 0.025 |
| Symptom trio* | 29 (14.2–48.0) | 30.0 (11.9–54.3) | >0.999 | 91.8 (90.2–93.2) | 88.2 (85.2–90.8) | 0.018 |
| New or changing radiological abnormality | 25.8 (11.9–44.6) | 25.0 (8.7–49.1) | >0.999 | 98.6 (97.8–99.1) | 98.9 (97.6–99.6) | 0.824 |
| Smear positive | ||||||
| First specimen | 22.6 (9.6–41.1) | 25.0 (8.7–49.1) | >0.999 | 99.1 (98.4–99.5) | 99.1 (97.9–99.7) | > 0.999 |
| Second specimen | 25.8 (11.9–44.6) | 20.0 (5.7–43.7) | 0.743 | 99.0 (98.3–99.4) | 99.6 (98.7–100.0) | 0.176 |
| Combined | 25.8 (11.9–44.6) | 25.0 (8.7–49.1) | >0.999 | 99.0 (98.3–99.4) | 99.1 (97.9–99.7) | > 0.999 |
| Culture positive | ||||||
| First specimen | 58.1 (39.1–75.5) | 80.0 (56.3–94.3) | 0.135 | 100.0 (99.7–100.0) | 100.0 (99.3–100.0) | — |
| Second specimen | 64.5 (45.4–80.8) | 65.0 (40.8–84.6) | >0.999 | 100.0 (99.7–100.0) | 100.0 (99.3–100.0) | — |
| Combined |
71 (52.0–85.8) |
90.0 (68.3–98.8) |
0.166 |
100.0 (99.7–100.0) |
100.0 (99.3–100.0) |
— |
Definition of abbreviation: CI = confidence interval.
There were 13 participants who were missing data on at least one of these screening methods; they have been removed from this analysis.
*
At least one of new or worsening cough (any duration), night sweats, or weight loss.