Pm. Kelly et al., A new, clinically-based algorithm for the diagnosis of HIV in African tuberculosis patients: cross-sectional analysis from Mzuzu, Malawi, INT J STD A, 10(4), 1999, pp. 231-236
We aimed to create an improved, clinically-based algorithm for the diagnosi
s of HIV in tuberculosis (TB) patients. Cross-sectional analysis was perfor
med on data from adult TB patients consecutively diagnosed at a Malawian di
strict level hospital. Of 225 patients, 187 with valid HIV results were inc
luded in the study. Sixty-seven per cent were HIV seropositive. Urban addre
ss, history of skin rash and sexually transmitted diseases (STDs) and, on e
xamination, oral candidiasis and lymphadenopathy, were associated with I-W
co-infection. Using these clinical characteristics, a case definition for H
IV was constructed. The Mzuzu clinical case definition was highly sensitive
(86%). The area under the receiver operating characteristic (ROC) curve wa
s 0.81, significantly larger than existing World Health Organization (WHO)
clinical case definitions. The Mzuzu definition is proposed for further eva
luation in settings where HIV serological testing is not readily available.