ArticleJournal of acquired immune deficiency syndromes (1999)2025
Characterization of the Targeted Universal Tuberculosis Testing Care Cascade Among People With HIV in PEPFAR-Supported Districts in South Africa.
Article in Journal of acquired immune deficiency syndromes (1999), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Feasibility, challenges, and solutions for implementing targeted universal tuberculosis testing: perceptions of healthcare professionals in South Africa.BMC health services research · 2026Article
- Operationalization of rapid molecular test coverage for tuberculosis in different international contexts: a scoping review.Revista da Escola de Enfermagem da U S P · 2026Article
- Determinants of drop-offs in the targeted universal tuberculosis testing care cascade among people with HIV in rural and urban facilities in South Africa.Southern African journal of HIV medicine · 2026Article
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Authors and funding
5 authors.
Funding
Abstract
backgroundSouth Africa implemented the World Health Organization-recommended Targeted Universal Tuberculosis Testing (TUTT) among high-risk groups regardless of symptoms in 2021, a shift from the former symptom-based testing approach. We assessed the TUTT care cascade to describe its implementation within the care continuum.
methodA descriptive retrospective analysis of routine TB/HIV program data from people with HIV (PWH) in high-burden districts-1 rural and 1 urban-was conducted for fiscal years (FY) 2022-2023.
resultsIn total, 104,139 and 104,431 PWH presented to care in FY2022 and FY2023, respectively. In FY2022, 33.1% received an Xpert MTB/RIF Ultra (Xpert) test, 4.8% tested positive, and 96.3% started treatment. Likewise, in FY2023, the Xpert testing coverage was 32.3%, test positivity was 4.8%, and 95.6% started treatment. In FY2022, 46.5% of PWH in the rural district received an Xpert test, and 2.5% tested positive, whereas in the urban district, 20.3% received an Xpert test, and 9.7% tested positive. In FY2023, Xpert test coverage in the rural district declined slightly to 43.6%, with 2.7% testing positive, whereas in the urban district, Xpert tests increased slightly to 21.7%, with 8.9% testing positive. Tuberculosis treatment initiation was high in both rural (95.2% in FY2022 and 94.8% in FY2023) and urban districts (96.9% in FY2022 and 96.1% in FY2023).
conclusionsLow Xpert test coverage indicates inconsistent TUTT implementation, highlighting the need for better training, mentorship, and supervision. The differences between rural and urban districts reflect variations in epidemiology, health care infrastructure, and testing practices.
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