Rachael M Burke, Saulos K Nyirenda, Timeo Mtenga, Hussein H Twabi, Elizabeth Joekes, Naomi F Walker, Rose Nyirenda, Ankur Gupta-Wright, Marriott Nliwasa, Katherine Fielding, Peter MacPherson, Elizabeth L Corbett
BACKGROUND: People with HIV (PHIV) admitted to hospital have high mortality, with tuberculosis (TB) being the major cause of death. Systematic use of new TB diagnostics could improve TB diagnosis and might improve outcomes. METHODS: We conducted a cluster randomised trial among adult PHIV admitted to Zomba Central Hospital, Malawi. Admission-days were randomly assigned to: enhanced TB diagnostics using urine lipoarabinomannan (LAM) antigen tests (SILVAMP-LAM, Fujifilm, Japan and Determine-LAM, Alere/Abbot, USA), digital chest X-ray with computer aided diagnosis (dCXR-CAD, CAD4TBv6, Delft, Netherlands), plus usual care ("enhanced TB diagnostics"); or usual care alone ("usual care")...
May 15, 2024: Clinical Infectious Diseases