ArticleBMC infectious diseases2017
Digital CXR with computer aided diagnosis versus symptom screen to define presumptive tuberculosis among household contacts and impact on tuberculosis diagnosis.
Article in BMC infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- Symptom- and chest-radiography screening for active pulmonary tuberculosis in HIV-negative adults and adults with unknown HIV status.The Cochrane database of systematic reviews · 2022Pooled it
- Prevention of tuberculosis in household members: estimates of children eligible for treatment.Bulletin of the World Health Organization · 2019Pooled it
- Pooled it
- Analysis of tuberculosis prevalence surveys in Africa: evidence to change the status quo in case finding.Frontiers in public health · 2026Review
- Using a Knowledge and Awareness Survey to Engage and Inform a Community-Based Tuberculosis Intervention among Nomads in Adamawa State, Nigeria.Tropical medicine and infectious disease · 2024Article
- Expanding molecular diagnostic coverage for tuberculosis by combining computer-aided chest radiography and sputum specimen pooling: a modeling study from four high-burden countries.BMC global and public health · 2024Article
- The yield of chest X-ray based versus symptom-based screening among patients with diabetes mellitus in public health facilities in Addis Ababa, Ethiopia.Journal of clinical tuberculosis and other mycobacterial diseases · 2022Article
- The Contribution of Chest Radiography to the Clinical Management of Children Exposed to Tuberculosis.American journal of respiratory and critical care medicine · 2022Article
- Evaluating the Effectiveness of a Novel Systematic Screening Approach for Tuberculosis among Individuals Suspected or Recovered from COVID-19: Experiences from Niger and Guinea.Tropical medicine and infectious disease · 2022Article
- Knowledge, attitudes and practices on childhood TB among healthcare workers.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2022Article
- Impact of intensified tuberculosis case finding at health facilities on case notifications in Cameroon: A controlled interrupted time series analysis.PLOS global public health · 2022Article
- Child Contact Case Management-A Major Policy-Practice Gap in High-Burden Countries.Pathogens (Basel, Switzerland) · 2021Review
- Provision of Decentralized TB Care Services: A Detect-Treat-Prevent Strategy for Children and Adolescents Affected by TB.Pathogens (Basel, Switzerland) · 2021Review
- Triage of Persons With Tuberculosis Symptoms Using Artificial Intelligence-Based Chest Radiograph Interpretation: A Cost-Effectiveness Analysis.Open forum infectious diseases · 2021Article
- Use of Digital Technology to Enhance Tuberculosis Control: Scoping Review.Journal of medical Internet research · 2020Article
- The impact of chest radiography and Xpert MTB/RIF testing among household contacts in Chennai, India.PloS one · 2020Article
- Article
- The performance and yield of tuberculosis testing algorithms using microscopy, chest x-ray, and Xpert MTB/RIF.Journal of clinical tuberculosis and other mycobacterial diseases · 2019Article
- Tuberculosis and HIV-An Update on the "Cursed Duet" in Children.Frontiers in pediatrics · 2019Review
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHousehold (HH) contact tracing is a strategy that targets high risk groups for TB. Symptom based screening is the standard used to identify HH contacts at risk for TB during HH contact tracing for TB. However, this strategy may be limited due to poor performance in predicting TB. The objective of this study was to compare CXR with Computer Aided Diagnosis (CAD) against symptom screen for defining presumptive TB and how TB detection changes with each method.
methodsHousehold contacts of consecutive index bacteriologically confirmed TB cases were visited by study teams and given TB/HIV education to raise awareness of the risk of TB following close contact with a TB patient. Contacts were encouraged to visit the health facility for screening; where symptoms history was obtained and opt out HIV testing was provided as part of the screening process. CXR was offered to all regardless of symptoms, followed by definitive sputum test with either Xpert MTB RIF or smear microscopy.
resultsAmong 919 HH contacts that presented for screening, 865 were screened with CXR and 464 (53.6%) had an abnormal CXR and the rest had a normal CXR. Among 444 HH contacts with valid sputum results, 274 (61.7%) were symptom screen positive and 255 (57.4%) had an abnormal CXR. Overall, TB was diagnosed in 32/444 (7.2%); 13 bacteriologically unconfirmed and 19 bacteriologically confirmed. Of 19 bacteriologically confirmed TB 8 (42.1%) were symptom screen negative contacts with an abnormal CXR and these 6/8 (75.0%) were HIV positive. Among the 13 bacteriologically unconfirmed TB cases, 7 (53.8%) were HIV positive and all had an abnormal CXR.
conclusionSymptom screen if used alone with follow on definitive TB testing only for symptom screen positive individuals would have missed eight of the 19 confirmed TB cases detected in this study. There is need to consider use of other screening strategies apart from symptom screen alone for optimal rule out of TB especially in HIV positive individuals that are at greatest risk of TB and present atypically.
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