Evidence map›Paper›PMID 42094165›Full record

ArticlemedRxiv : the preprint server for health sciences2026

Performance of Human and Computer-aided Evaluation of Digital Chest Radiography for Community-based Screening of Asymptomatic Tuberculosis.

Sarah Nyangu, Humphrey Mulenga, Simon C Mendelsohn, Tahlia Perumal, Michele Tameris, Tumelo Moloantoa, Stephanus T Malherbe, Firdows Noor, Justin Shenje, Nicolette Tredoux and 16 more

Abstract readPreprint
PubMed Full text at PMC Publisher
In one paragraph

Article in medRxiv : the preprint server for health sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Sarah NyanguSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Humphrey MulengaSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Simon C MendelsohnSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.ORCID 0000-0002-4054-2766
Tahlia PerumalCentre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine and UCT Lung Institute & South African MRC/UCT Centre for the Study of Antimicrobial Resistance, University of Cape Town, Cape Town, South Africa.
Michele TamerisSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Tumelo MoloantoaPerinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa.
Stephanus T MalherbeSouth African Medical Research Council Centre for Tuberculosis Research, Division of Immunology, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Firdows NoorSouth African Medical Research Council Centre for Tuberculosis Research, Division of Immunology, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Justin ShenjeSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Nicolette TredouxSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Angelique Kany Kany LuabeyaSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Fernanda MaruriVanderbilt Tuberculosis Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Ravindre PanchiaPerinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa.
Khuthadzo HlongwanePerinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa.
Kim StanleySouth African Medical Research Council Centre for Tuberculosis Research, Division of Immunology, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Yuri F van der HeijdenVanderbilt Tuberculosis Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Kate HadleySouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Neil MartinsonPerinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa.
Keertan DhedaCentre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine and UCT Lung Institute & South African MRC/UCT Centre for the Study of Antimicrobial Resistance, University of Cape Town, Cape Town, South Africa.
Al LeslieAfrica Health Research Institute (AHRI), Durban, South Africa.
Bernard FourieDepartment of Medical Microbiology, University of Pretoria (UP) Faculty of Health Sciences, Pretoria, South Africa.
Gerhard WalzlSouth African Medical Research Council Centre for Tuberculosis Research, Division of Immunology, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Thomas J ScribaSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.ORCID 0000-0002-0641-1359
Timothy R SterlingVanderbilt Tuberculosis Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Mark HatherillSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease & Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.ORCID 0000-0003-3491-1809
RePORT South Africa Study Team

Funding

Evaluation of new diagnostics for incident, active and recurrent TB (ENDx-Tb)U01AI152075 · NIAID · STELLENBOSCH UNIVERSITY · PI BELISLE, JOHN T, SUTHERLAND, JAYNE · 2020 to 2025
$7.1M
NIAID NIH HHS U01 AI152075
6 · The paper itself

Abstract

Background: The World Health Organisation (WHO) recommends digital chest radiography (dCXR) with computer-aided detection (CAD) for tuberculosis (TB) screening of individuals >15 years of age. Methodology: Adults (≥18 years) were enrolled (March 2021-December 2022) in South Africa into a community-based Screening Cohort (household contacts) and a facility-based Triage Cohort (symptomatic clinic attendees). Microbiologically-confirmed pulmonary TB required positive sputum culture and/or Xpert Ultra. Asymptomatic TB was diagnosed in participants without TB symptoms. dCXR were read by blinded human readers and qXR CAD (0.5 threshold; Qure.AI, India). Results: dCXR from 1,353 participants (886 Screening Cohort; 467 Triage Cohort) were analysed. Microbiologically-confirmed TB occurred in 48 (5.4%) Screening Cohort [9 symptomatic (19%) and 39 asymptomatic (81%)]; and 116 (24.8%) Triage Cohort (all symptomatic) participants. dCXR sensitivity (human readers) for asymptomatic TB in the Screening Cohort was 56.4%, vs. 72.4% for symptomatic TB in the Triage Cohort (difference -16%; 95%CI -2.9 to -29.1); with specificities 94.1% and 81.2%, respectively. Corresponding qXR CAD sensitivities were 69.2% vs. 83.6% (difference -14.4%; 95%CI -26 to -2.8), with specificities 89.3% and 73.5%, respectively. The difference in dCXR sensitivity and specificity for asymptomatic TB between qXR CAD and human readers was 12.8% (95%CI -0.48 to 26.1) and -4.8% (95%CI -12.4 to 28.2), respectively. Conclusion: Sensitivity of community-based dCXR screening for microbiologically-confirmed asymptomatic TB among household contacts was lower than for facility-based triage of symptomatic TB, but approached 70% with CAD. Neither human reader nor qXR CAD evaluation met WHO targets for a TB screening test (90% sensitivity; 80% specificity).

Indexed as

AsymptomaticCADdigital CXRHousehold contactsscreeningTuberculosis

Identifiers

PMID42094165
PMCPMC13142598

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.