Table 3.
Performance of the World Health Organization Tuberculosis (WHO-TB) Screening Instrumenta Alone and WHO-TB Screening Followed by the Clinical Scoring Algorithmb for Categorization for the Likelihood of TB in HIV-Infected Adults at Ethiopian Health Centers
| Categorization for Likelihood of TB | No. of Positive Variables | No. of Subjects | TB Cases | Smear-Positivec | Xpert-Positivec | Culture-Positived |
|---|---|---|---|---|---|---|
| WHO TB screening algorithmc (n = 784) | 0 | 159 | 10 (6) | 1 (10) | 4 (40) | 9 (90) |
| 1–2 | 309 | 38 (12) | 8 (21) | 23 (61) | 36 (95) | |
| 3–4 | 316 | 88 (28) | 22 (25) | 69 (78) | 77 (88) | |
| Clinical scoring algorithme (n = 569) | 0–1 | 255 | 20 (8) | 4 (20) | 11 (55) | 17 (85) |
| 2–3 | 280 | 77 (28) | 16 (21) | 58 (75) | 69 (90) | |
| 4–5 | 34 | 19 (56) | 7 (37) | 16 (84) | 17 (89) |
Data are presented as No. (%) unless otherwise specified.
Abbreviations: HIV, human immunodeficiency virus; TB, tuberculosis; WHO, World Health Organization.
a The WHO-TB symptom screening algorithm includes 4 symptoms (fever, weight loss, night sweats, and/or cough of any duration); persons reporting any of these symptoms are categorized as WHO-TB+.
b The clinical scoring algorithm is intended for use in WHO-TB+ subjects, and includes 5 variables (cough, Karnofsky score ≤80, mid-upper arm circumference <20 cm, hemoglobin <10 g/dL, and peripheral lymphadenopathy). Each of these variables confers 1 point in the score (possible range, 0–5 points).
c Seven hundred eighty-four persons with all 4 recorded symptoms were included in the analysis; 136 had TB.
d Percentage was calculated from bacteriologically confirmed TB cases with the same range of variables or clinical scores.
e Including WHO-TB+ subjects (n = 625). Five hundred sixty-nine persons with recordings for all variables were included in the analysis; 116 had TB.