CD4 and pneumocystosis: This is in marked contrast to many other indicators of AHD, such as CD4 count testing, which requires extensive laboratory infrastructure [12], or other indicator diseases such as disseminated tuberculosis or pneumocystis pneumonia (PCP), where there is a lack of sensitive diagnostics, often considerable diagnostic uncertainty clinically, and a large proportion of disease in the community rather than healthcare facilities, making accurate case ascertainment difficult [13, 14].