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Dartmouth study reveals flaws in screening for TB; Cases in 3rd world HIV patients may go undetected

HANOVER, NH -- New findings from a Dartmouth Medical School collaboration in Tanzania may alter assumptions about the diagnosis of tuberculosis in HIV-infected people, and prompt a major change in way TB testing is routinely done in the developing world.

Writing in the journal, "Clinical Infectious Diseases," researchers found that while the co-existence of HIV and TB is well-known, traditional screening methods for TB are allowing significant number of cases of subclinical, active tuberculosis to go undetected. In apparent response to the these findings, the international physicians' group, Mdecins Sans Frontires (Doctors Without Borders), has recommended that all HIV/AIDS patients receive the more sensitive and accurate TB culture test used in the Tanzania research project.

This latest research was reported by investigators in the DARDAR Health Study, a collaboration between Dartmouth Medical School and the Muhimbili University College of Health Sciences in Dar Es Salaam, Tanzania. C. Fordham von Reyn, MD, Chief of the Section of Infectious Disease and International Health at Dartmouth-Hitchcock Medical Center, is the leader of the DARDAR project and author of the new study with Lillian Mtei MD, and other colleagues in Tanzania.

"Our study team found that when we used the same comprehensive diagnostic approach to tuberculosis available in industrialized countries 15% of HIV-infected patients in Tanzania had previously unrecognized active tuberculosis," von Reyn said. "These findings emphasize the importance of improving the availability of TB diagnostic tests in the developing world."

In the developing world, TB is the leading cause of death among people with HIV infection. Thus, diagnosis and proper treatment of TB is a critical component of HIV treatment in these regions. Unfortunately, HIV infection can actually make TB more difficult to diagnose, creating additional challenges for health workers.

The DARDAR team, wor
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Contact: Deborah Kimbell
Deborah.Kimbell@dartmouth.edu
603-653-1913
Dartmouth Medical School
15-Jun-2005


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