ArticlePloS one2016
Chest Radiographic Patterns and the Transmission of Tuberculosis: Implications for Automated Systems.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 27 citations in OpenAlex.
- Characteristics of Plausible Source Cases Responsible for Recent Mycobacterium tuberculosis Transmission, United States, 2018-2022.Emerging infectious diseases · 2026Article
- Telomere shortening correlates with immune dysregulation and severity in pulmonary tuberculosis.BMC pulmonary medicine · 2026Article
- Impact of demographic and clinical information on pulmonary tuberculosis diagnosis via chest X-ray interpretation: a cross-sectional study in an Australian tertiary hospital.BMC infectious diseases · 2026Article
- Article
- A comparison of the chest radiographic and computed tomographic features of subclinical pulmonary tuberculosis.Scientific reports · 2022Article
- How much do smear-negative patients really contribute to tuberculosis transmissions? Re-examining an old question with new tools.EClinicalMedicine · 2022Article
- Article
- Clinical features of atypical tuberculosis mimicking bacterial pneumonia.Open medicine (Warsaw, Poland) · 2021Article
- Prompt recognition of infectious pulmonary tuberculosis is critical to achieving elimination goals: a retrospective cohort study.BMJ open respiratory research · 2020Article
- Is there a fundamental flaw in Canada's post-arrival immigrant surveillance system for tuberculosis?PloS one · 2019Article
- Epidemiological and genomic determinants of tuberculosis outbreaks in First Nations communities in Canada.BMC medicine · 2018Article
- Empiric anti-tuberculosis treatment is not always a right way in patients who had have poorly controlled diabetes mellitus and presented with pulmonary cavities over upper lungs in tuberculosis endemic countries.Epidemiology and infection · 2018Article
- Predicting pulmonary tuberculosis in immigrants: a retrospective cohort study.ERJ open research · 2018Article
- TST positivity in household contacts of tuberculosis patients: a case-contact study in Malawi.BMC infectious diseases · 2017Article
- Article
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6 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundComputer-aided detection to identify and diagnose pulmonary tuberculosis is being explored. While both cavitation on chest radiograph and smear-positivity on microscopy are independent risk factors for the infectiousness of pulmonary tuberculosis it is unknown which radiographic pattern, were it detectable, would provide the greatest public health benefit; i.e. reduced transmission. Herein we provide that evidence.
objectives1) to determine whether pulmonary tuberculosis in a high income, low incidence country is more likely to present with "typical" adult-type pulmonary tuberculosis radiographic features and 2) to determine whether those with "typical" radiographic features are more likely than those without such features to transmit the organism and/or cause secondary cases.
methodsOver a three-year period beginning January 1, 2006 consecutive adults with smear-positive pulmonary tuberculosis in the Province of Alberta, Canada, were identified and their pre-treatment radiographs scored by three independent readers as "typical" (having an upper lung zone predominant infiltrate, with or without cavitation but no discernable adenopathy) or "atypical" (all others). Each patient's pre-treatment bacillary burden was carefully documented and, during a 30-month transmission window, each patient's transmission events were recorded. Mycobacteriology, radiology and transmission were compared in those with "typical" versus "atypical" radiographs.
findingsA total of 97 smear-positive pulmonary tuberculosis cases were identified, 69 (71.1%) with and 28 (28.9%) without "typical" chest radiographs. "Typical" cases were more likely to have high bacillary burdens and cavitation (Odds Ratios and 95% Confidence Intervals: 2.75 [1.04-7.31] and 9.10 [2.51-32.94], respectively). Typical cases were also responsible for most transmission events-78% of tuberculin skin test conversions (p<0.002) and 95% of secondary cases in reported close contacts (p<0.01); 94% of secondary cases in "unreported" contacts (p<0.02).
conclusionAs a group, smear-positive pulmonary tuberculosis patients with typical radiographic features constitute the greatest public health risk. This may have implications for automated detection systems.
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