Southern African Journal of Infectious Diseases最新文献

{"title":"A descriptive study of vancomycin use at Red Cross War Memorial Children’s Hospital, Cape Town","authors":"Leonore Greybe, Brian S. Eley, Hafsah D. Tootla, Anna M.M. Botha, Wisdom Basera, James J.C. Nuttall","doi":"10.4102/sajid.v38i1.528","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.528","url":null,"abstract":"Background Antimicrobial stewardship principles guide the clinical use of antimicrobials, including vancomycin, but paediatric vancomycin prescribing practices have not been evaluated in South Africa. Objectives To document the use, prescribing practices and monitoring of intravenous vancomycin and the spectrum of bacteria isolated on microbiological culture in children treated with intravenous vancomycin during a 12-month period at Red Cross War Memorial Children’s Hospital (RCWMCH). Method A retrospective audit of intravenous vancomycin use in children admitted to RCWMCH during 2019 was performed. Results All 158 vancomycin prescription episodes for 143 children were included. Overall usage of intravenous vancomycin was 63 days of therapy per 1000 patient days (interquartile range [IQR]: 38–72). The median starting dose was 15 mg/kg per dose (IQR: 14–15) and median daily dose was 45 mg/kg per day (IQR: 43–60). Vancomycin was prescribed as empiric (127/158, 80%) and directed (31/158, 20%) treatment. The median duration of treatment for the directed group (7 days) was longer than the empiric group (4 days) (p = 0.001). Vancomycin serum trough concentrations were performed in 65/98 (66%) episodes where vancomycin treatment exceeded 3 days, with only 16/65 (25%) of these samples obtained before the fourth dose. Prolonged antibiotic treatment of 14 days or more was not associated with Gram-positive bacteria on culture (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 0.17–4.2). Conclusion Dosing errors, prolonged empiric treatment and inappropriate vancomycin monitoring were problems associated with vancomycin prescriptions. Contribution The study identified multiple opportunities for improved vancomycin prescribing and monitoring. Further research and implementation of improved prescribing practices could contribute to the preservation of vancomycin as an effective antibiotic.","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"93 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135584199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probable endometrial tuberculosis in a patient with rhupus.","authors":"Nimmisha Govind,&nbsp;Tamara Romanini,&nbsp;Lai Ling Winchow","doi":"10.4102/sajid.v38i1.543","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.543","url":null,"abstract":"<p><p>Endometrial tuberculosis (TB) is an uncommon manifestation of disseminated TB. Rhupus is the coexistence of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). We describe a case of endometrial TB in rhupus patient an immunosuppressed.</p><p><strong>Contribution: </strong>We describe an uncommon presentation of disseminated TB, endometrial TB, in a rare rheumatic disease, rhupus. A high index of suspicion for TB is imperative in immunocompromised patients presenting with chronic urogenital symptoms especially in an endemic area.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"543"},"PeriodicalIF":0.9,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10623593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of pericardial schistosomiasis and non-Hodgkin high grade B-cell lymphoma.","authors":"Michael J Boyd,&nbsp;Marc Mendelson,&nbsp;Sipho K Dlamini,&nbsp;Sean Wasserman,&nbsp;Ghaalied Fakier,&nbsp;Riyaadh Roberts,&nbsp;Nectarios S Papavarnavas","doi":"10.4102/sajid.v38i1.524","DOIUrl":"10.4102/sajid.v38i1.524","url":null,"abstract":"<p><p>Chronic schistosomiasis affects either the genitourinary or gastrointestinal tract. Rarely, schistosomes cause ectopic disease, such as in the case of a South African woman from a non-endemic province, who presented with suspected pericardial tamponade because of tuberculosis. However, histology and polymerase chain reaction from pericardial biopsy confirmed <i>Schistosoma haematobium.</i> A finding of mediastinal non-Hodgkin lymphoma came to light when our patient's clinical condition unexpectedly deteriorated.</p><p><strong>Contribution: </strong>This case highlights an unusual manifestation of schistosomiasis.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"524"},"PeriodicalIF":0.9,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10546256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41165364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe efavirenz associated neurotoxicity: A retrospective cohort study.","authors":"Priyadarshini Arnab,&nbsp;Roland Croxford,&nbsp;Janet Scott,&nbsp;Sameshan Perumal,&nbsp;Zahraa Mohammed,&nbsp;Lubbe Wiesner,&nbsp;Karen Cohen,&nbsp;Sean Wasserman","doi":"10.4102/sajid.v38i1.522","DOIUrl":"10.4102/sajid.v38i1.522","url":null,"abstract":"Background Efavirenz (EFV) is associated with neuropsychiatric symptoms. Severe neurotoxicity has been reported but the clinical phenotype and risk factors are poorly defined. Objectives To characterise clinical presentations, risk factors and outcomes to help clinicians recognise severe neurotoxicity earlier. Method The authors retrospectively identified adults with supratherapeutic EFV concentrations (> 4 mg/L) obtained during routine clinical care in Cape Town, South Africa. Clinical and laboratory data at the time of EFV quantification were extracted from medical records. Logistic regression was performed to identify associations with neuropsychiatric symptoms, and with severe neurotoxicity. Results Eighty one patients were included; 62 with neuropsychiatric manifestations (most frequently ataxia [n = 20] and psychomotor slowing [n = 24]); and 19 with hepatotoxicity. Overall, 28 (34.6%) were male, 49 (60.5%) had concomitant isoniazid exposure, and median EFV concentration was 12.1 mg/L (interquartile range [IQR]: 6.6–20.0). Neuropsychiatric symptoms were associated with longer duration of EFV therapy, adjusted odds ratio (aOR) 1.3/180-day increment (95% confidence interval [CI]: 1.0–1.7); higher EFV concentrations, aOR 1.2/1 mg/L increase (95% CI: 1.0–1.4) and isoniazid exposure, aOR 8.2 (95% CI: 2.5–26.7). Severe neuropsychiatric symptoms occurred in 47 (75%) patients at a median of 5.9 months (IQR: 2.1–40.8) after EFV initiation. Severe symptoms odds were 1.2-fold higher (95% CI: 1.1–1.4) per 1 mg/L increase in EFV concentration. Symptoms resolved completely within 1 month in 25 (76%) patients with severe neurotoxicity who discontinued EFV. Conclusion A concentration–effect relationship for severe neurotoxicity exists, which occurred late and resolved in most patients after EFV discontinuation. Contribution The authors highlighted clinical heterogeneity and morbidity of EFV-associated neurotoxicity.","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"522"},"PeriodicalIF":0.9,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10397354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41164412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low prevalence of <i>Schistosoma haematobium</i> infection in pregnant women in Buffalo City district.","authors":"Remco P H Peters, Mandisa Mdingi, Hyunsul Jung, Freedom Mukomana, Ranjana M S Gigi, Andrew Medina-Marino, Jeffrey D Klausner","doi":"10.4102/sajid.v38i1.521","DOIUrl":"10.4102/sajid.v38i1.521","url":null,"abstract":"Adverse pregnancy outcomes such as stillbirth, pre-term birth and low birth weight are common in South Africa. The aetiology of these conditions is multifactorial and infections play an important role. Studies have shown an increased risk of adverse pregnancy outcomes associated with sexually transmitted infection (STI) during pregnancy.1 Urogenital Schistosoma haematobium is another infection that should be considered for adverse pregnancy outcomes.2","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"521"},"PeriodicalIF":0.9,"publicationDate":"2023-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331169/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9805266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ebola outbreak in Guinea, 2021: Clinical care of patients with Ebola virus disease.","authors":"Boyo C Pare, Alseny M Camara, Aminata Camara, Moussa Kourouma, Koivogui Enogo, Mohammed S Camara, Laurent Akilimali, Sayadi Sani, Eric Barte de Sainte Fare, Papys Lame, Nicolas Mouly, Marta Lado Castro-Rial, Billy Sivahera, Mahamoud S Cherif, Abdoul H Beavogui, Dally Muamba, Joachim B Tamba, Barry Moumié, Richard Kojan, Hans-Joerg Lang","doi":"10.4102/sajid.v38i1.454","DOIUrl":"10.4102/sajid.v38i1.454","url":null,"abstract":"<p><strong>Background: </strong>Experience from the Zaire Ebolavirus epidemic in the eastern Democratic Republic of the Congo (2018-2020) demonstrates that early initiation of essential critical care and administration of Zaire Ebolavirus specific monoclonal antibodies may be associated with improved outcomes among patients with Ebola virus disease (EVD).</p><p><strong>Objectives: </strong>This series describes 13 EVD patients and 276 patients with suspected EVD treated during a Zaire Ebolavirus outbreak in Guinea in 2021.</p><p><strong>Method: </strong>Patients with confirmed or suspected EVD were treated in two Ebola treatment centres (ETC) in the region of N'zérékoré. Data were reviewed from all patients with suspected or confirmed EVD hospitalised in these two ETCs during the outbreak (14 February 2021 - 19 June 2021). Ebola-specific monoclonal antibodies, were available 2 weeks after onset of the outbreak.</p><p><strong>Results: </strong>Nine of the 13 EVD patients (age range: 22-70 years) survived. The four EVD patients who died, including one pregnant woman, presented with multi-organ dysfunction and died within 48 h of admission. All eight patients who received Ebola-specific monoclonal antibodies survived. Four of the 13 EVD patients were health workers. Improvement of ETC design facilitated implementation of WHO-recommended 'optimized supportive care for EVD'. In this context, pragmatic clinical training was integrated in routine ETC activities. Initial clinical manifestations of 13 confirmed EVD patients were similar to those of 276 patients with suspected, but subsequently non confirmed EVD. These patients suffered from other acute infections (e.g. malaria in 183 of 276 patients; 66%). Five of the 276 patients with suspected EVD died. One of these five patients had Lassa virus disease and a coronavirus disease 2019 (COVID-19) co-infection.</p><p><strong>Conclusion: </strong>Multidisciplinary outbreak response teams can rapidly optimise ETC design. Trained clinical teams can provide WHO-recommended optimised supportive care, including safe administration of Ebola-specific monoclonal antibodies. Pragmatic training in essential critical care can be integrated in routine ETC activities.</p><p><strong>Contribution: </strong>This article describes clinical realities associated with implementation of WHO-recommended standards of 'optimized supportive care' and administration of Ebola virus specific treatments. In this context, the importance of essential design principles of ETCs is underlined, which allow continuous visual contact and verbal interaction of health workers and families with their patients. Elements that may contribute to further quality of care improvements for patients with confirmed or suspected EVD are discussed.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"454"},"PeriodicalIF":1.4,"publicationDate":"2023-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9389697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 vaccine hesitancy among pregnant women in an antenatal clinic in Durban, South Africa.","authors":"Sahra Ashkir,&nbsp;Tashlen Abel,&nbsp;Olive P Khaliq,&nbsp;Jagidesa Moodley","doi":"10.4102/sajid.v38i1.516","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.516","url":null,"abstract":"<p><strong>Background: </strong>Mass administration of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the most efficient intervention against the coronavirus disease 2019 (COVID-19) pandemic. Recently, vaccinations were shown to be safe and effective during pregnancy. However, vaccination rates are low in low- and middle-income countries, and vaccine hesitancy is a major limiting factor.</p><p><strong>Objectives: </strong>To investigate the rate of COVID-19 vaccine hesitancy among pregnant women.</p><p><strong>Method: </strong>A cross-sectional questionnaire-based investigation of 313 unvaccinated pregnant women attending an antenatal clinic in Durban, South Africa (SA). The questionnaire included clinical and socio-demographic data, and reasons for vaccine hesitancy were recorded and evaluated.</p><p><strong>Results: </strong>Of 313 women participating, 126 (40.3%) were vaccinated against COVID-19, 21/313 = 6.7%; for those unvaccinated, 21/187 (13.9%) were planning to be vaccinated. However, most unvaccinated women, 174 of 187 (93%), showed COVID-19 vaccine hesitancy.</p><p><strong>Conclusion: </strong>The COVID-19 vaccination hesitancy among pregnant women in Durban, SA, is exceptionally high. This requires urgent attention by the relevant health authorities (both professional health organisations and the SA Department of Health) as many countries experience different waves of the variants of SARS-CoV-2 and herd immunity may not have been achieved.</p><p><strong>Contribution: </strong>This study showed a high vaccine acceptance hesitancy rate among pregnant women in SA.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"516"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10476234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10168395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic profile of HIV and helminth-coinfected adults in KwaZulu-Natal, South Africa.","authors":"Miranda N Mpaka-Mbatha,&nbsp;Pragalathan Naidoo,&nbsp;Md Mazharul Islam,&nbsp;Ravesh Singh,&nbsp;Zilungile L Mkhize-Kwitshana","doi":"10.4102/sajid.v38i1.466","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.466","url":null,"abstract":"<p><strong>Background: </strong>Helminth and HIV infections are endemic among poor populations. Studies investigating the socio-demographic and economic risk factors associated with dual HIV and helminth coinfection are scarce.</p><p><strong>Objectives: </strong>This study aimed to describe risk factors associated with HIV and helminth coinfections among peri-urban South African adults residing in poorly developed areas with high poverty levels, lack of sanitation and a clean water supply.</p><p><strong>Method: </strong>Adult participants (<i>n</i> = 414) were recruited from clinics in the south of Durban, KwaZulu-Natal, South Africa. Participants' demographic, socio-economic, sanitation and household information, anthropometric measurements and HIV status were collected. Stool samples were donated for coproscopy to detect helminths using the Kato-Katz and Mini Parasep techniques. Blood was collected to confirm participants' HIV status and to determine <i>Ascaris lumbricoides</i>-specific immunoglobulin E (IgE) and immunoglobulin G4 (IgG4) levels to improve microscopy sensitivity.</p><p><strong>Results: </strong>Overall coinfection was 15%, and single helminth and HIV prevalence were 33% and 52%, respectively. <i>Ascaris lumbricoides</i> was predominant (18%). Univariate analysis of variance (ANOVA) showed that coinfection was 11.9% and 19.8%, respectively, among the 18-34 years and 35-59 years age groups (<i>p</i> = 0.0006), 16.4% and 19.9%, respectively, for the no income and < R1000.00 groups (<i>p</i> = 0.0358) and 22.8% and 17.1%, respectively, for the pit or public toilets and toilets not connected to sewage groups (<i>p</i> = 0.0007).</p><p><strong>Conclusion: </strong>Findings suggest that the dual infection with HIV and helminth infections among adults residing in under-resourced areas with poor sanitary conditions is frequent. Older age, poor toilet use and low income are associated with coinfection. More attention is required to break the cycle of coinfections and possible disease interactions.</p><p><strong>Contribution: </strong>The study highlights the importance of determining and treating helminth infections among adult population during HIV and helminth coinfection and the influence of poor sanitation and socioeconomic status on disease transmission.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"466"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9252874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical application of Vitek-derived minimum inhibitory concentration values: Proof of concept study.","authors":"Warren Lowman","doi":"10.4102/sajid.v38i1.498","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.498","url":null,"abstract":"<p><strong>Background: </strong>Minimum inhibitory concentration (MIC) values are useful in guiding appropriate antimicrobial therapy however, routine provision and interpretation of MIC values to guide clinical decision-making is challenging.</p><p><strong>Objectives: </strong>This proof of concept study aims to demonstrate the clinical utility and application of Vitek^®-derived MIC values through categorisation of clinical isolates as wild type.</p><p><strong>Method: </strong>A random selection of clinically relevant Gram negative isolates routinely tested on the Vitek^® instrument were included. The Vitek^® MIC values, for selected antimicrobials at the lowest calling range of that card, were compared to the broth microdilution reference method. The specified end-point was concordance between the two results if the reference MIC was less than or equal to the EUCAST-defined epidemiological cut-off value (ECOFF) for that drug-bug combination.</p><p><strong>Results: </strong>A total of 525 isolates were included (468 Enterobacterales and 57 <i>Pseudomonas aeruginosa</i>), with an overall concordance rate of 96.4% (508/525). Correct ECOFF categorisation by the Vitek^® was highest for ceftazidime and piperacillin (100%, <i>n</i> = 48 and <i>n</i> = 55, respectively) and lowest for cefepime (81.8%, <i>n</i> = 66).</p><p><strong>Conclusion: </strong>Vitek^®-derived MIC values can be used to categorise organisms as wild-type if the MIC is reported at the card's lowest calling range (≤) as there is high likelihood that the MIC is at or below the ECOFF. This has important implications for antimicrobial management, assisting in choice of agent and in improving probability of target attainment for desired pharmacodynamic targets which can translate into improved clinical outcomes.</p><p><strong>Contribution: </strong>Minimum inhibitory concentration data from an automated antimicrobial susceptibility testing instrument can be used to guide clinical decisions.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"498"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10091181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9308997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of C-reactive protein and a differentiated white cell count in diagnosing tuberculosis.","authors":"Gideon Ruder,&nbsp;Richard M N Carter,&nbsp;Gina Joubert","doi":"10.4102/sajid.v38i1.481","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.481","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) is treatable with a high cure rate. In South Africa, 70% of pulmonary TB is microbiologically confirmed. Autopsy studies of HIV-positive people found 45.7% undiagnosed TB cases.</p><p><strong>Objectives: </strong>The primary objective investigated whether CRP and a differentiated white cell count (WCC) and ratios thereof are useful screening tools for TB.</p><p><strong>Method: </strong>This retrospective cross-sectional study included adult patients admitted to two tertiary hospitals in Bloemfontein with TB workups between April 2016 and September 2019. National Health Laboratory Service (NHLS) provided laboratory data. Tuberculosis Xpert^® MTB/RIF, Xpert^® MTB/RIF Ultra and TB culture were used as reference standard for TB diagnosis.</p><p><strong>Results: </strong>The study population comprised 1294 patients; 15.1% had TB, 56.0% were male and 63.1% HIV-positive. Patients with TB were younger (<i>p</i> < 0.0001; 95% CI: -8;-3 years). In the total population, WCC had the highest area under the curve (0.59). White cell count (<i>p</i> < 0.0001), neutrophils (<i>p</i> = 0.0003) and lymphocytes (<i>p</i> = 0.0394) were lower in TB patients, and CRP-WCC ratio (CWR) (<i>p</i> = 0.0009) and CRP-lymphocyte ratio (CLR) (<i>p</i> = 0.0386) higher. In HIV-positive patients, WCC (<i>p</i> = 0.0003), neutrophils (<i>p</i> = 0.002) and lymphocytes (<i>p</i> = 0.0491) were lower in TB patients and CWR (<i>p</i> = 0.0043) higher. No parameter reached the World Health Organization screening targets of 70% specificity with 90% sensitivity.</p><p><strong>Conclusion: </strong>Differentiated WCC and CRP are not useful in screening hospitalised patients for TB in our setting.</p><p><strong>Contribution: </strong>Our study guides future research to augment current screening and diagnostic algorithms for TB, specifically in advanced HIV disease.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"481"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10244949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9965046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}