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[14] Autopsy studies have found disseminated TB in 40 54% of HIV-infected people in HIV prevalent countries, many of whom were undiagnosed prior to death.
The strategy of testing people from prevalent countries promises good value for money.
In addition, varying refusal rates have been reported from other high HIV prevalent countries ranging from 12-87% [ 14- 17].
Our proposal addresses the diagnostic problem by identifying a clear high-risk population originating in prevalent countries.
■ Strategy F: test all patients from prevalent countries as well as those with an ALT exceeding twice the upper-limit of normal.
As in the more prevalent countries, caries may be due to an increased availability of refined sugar products without a concurrent rise in oral health awareness.
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To our knowledge, this is the largest study reporting such results in a high TB prevalent country affected with HIV infection.
Despite, being a low HIV prevalent country, Liberia has attracted support from NGOs and multilateral agencies to scale up and strengthen Prevention of Mother-to-Child Transmission (PMTCT) services.
■ Strategy E: combine the two previous strategies by testing those who have an ALT exceeding twice the upper limit of normal and who also originate from a prevalent country.
This highlights the need to identify within low HIV-prevalent countries the settings where the guideline should be implemented.
Joint management of clinical HIV treatment and care with maternity services in high HIV-prevalent countries is now essential.
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