What are the barriers to diagnosing tuberculosis in HIV/AIDS clients?
In the past, TB diagnosis was easier, but now, the existence of advanced HIV disease hinders the standard tests used to diagnose TB. In essence, we are dealing with the limitations of old technology. It can be very difficult to rule out active TB infection in people with HIV. In hospitals, you see very ill patients, and x-rays don’t always show whether there is active TB. Sputum smear microscopy, the primary diagnostic test for active and infectious tuberculosis, cannot detect TB that has spread from the lungs to other parts of the body, a common complication in people with HIV. Wherever HIV co-infection is prevalent, smear microscopy, at best, can detect around 45-60% of people who have active TB. If smears are negative, it may still be possible to find active TB by sending a specimen out to the regional reference laboratory for ‘culturing,’ but the process can take more than a month. Most laboratories have inadequate capacity to diagnose TB in PLWHA. The result has been increases in
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