Assessment on HIV Testing Among Newly Diagnosed Tuberculosis Patients at the National Hospital for Respiratory Diseases (NHRD) in Welisara, Sri Lanka during the first quarter of 2024

This study was aimed to assess and review the current practice of screening of HIV in TB patients within NHRD Welisara hospital against the recommended standard practice by the National Guideline and the cross-sectional study was conducted on newly diagnosed tuberculosis patients. Simple random sampling was used to collect data from a sample size of 163, with retrospective data gathered from patient ward records. Data quality was enhanced by reviewing clinic and laboratory records, and a secure Excel spreadsheet was maintained for data management.

Results: Data indicated that 12.3% (n=20) lacked documentation for HIV testing. Of the 143 patients tested, only 43.4% (n=62) were tested while in the ward; others were tested at follow-up clinics. The average time from TB confirmation to HIV testing was 4.8 days (range: 0 to 36 days). Though average post-TB diagnosis hospital stay was 20.9 days (range: 0 to 129 days) for HIV tested patients, those without HIV testing had an average stay of 12 days (range: 0 to 40 days).

The primary reason for not undergoing HIV testing was patient transfer, but with an average ward stay of 14.6 days post-TB diagnosis. Other factors included patient death, disappearance, or leaving against medical advice. Notably, four patients were discharged without HIV testing, having stayed 3 to 11 days post-TB diagnosis. Most patients (51.7%, n=74) were tested at the NHRD laboratory, while 39.9% (n=57) were tested at an STD clinic, and only 5.6% underwent RDTs in the ward.

Conclusion: Those without HIV testing had prolonged hospital stays, suggesting missed opportunities. Underutilization of RDTs by ward staff needs attention. Incorporating HIV test results into the discharge checklist may prevent these oversights. Therefore, findings will be presented to the director-NHRD aiming to initiate a discussion and create an audit cycle.