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‘If not TB, what could it be?’ Chest X-ray findings from the 2016 Kenya Tuberculosis Prevalence Survey
- Source :
- Thorax
- Publication Year :
- 2021
- Publisher :
- BMJ Publishing Group, 2021.
-
Abstract
- BackgroundThe prevalence of diseases other than TB detected during chest X-ray (CXR) screening is unknown in sub-Saharan Africa. This represents a missed opportunity for identification and treatment of potentially significant disease. Our aim was to describe and quantify non-TB abnormalities identified by TB-focused CXR screening during the 2016 Kenya National TB Prevalence Survey.MethodsWe reviewed a random sample of 1140 adult (≥15 years) CXRs classified as ‘abnormal, suggestive of TB’ or ‘abnormal other’ during field interpretation from the TB prevalence survey. Each image was read (blinded to field classification and study radiologist read) by two expert radiologists, with images classified into one of four major anatomical categories and primary radiological findings. A third reader resolved discrepancies. Prevalence and 95% CIs of abnormalities diagnosis were estimated.FindingsCardiomegaly was the most common non-TB abnormality at 259 out of 1123 (23.1%, 95% CI 20.6% to 25.6%), while cardiomegaly with features of cardiac failure occurred in 17 out of 1123 (1.5%, 95% CI 0.9% to 2.4%). We also identified chronic pulmonary pathology including suspected COPD in 3.2% (95% CI 2.3% to 4.4%) and non-specific patterns in 4.6% (95% CI 3.5% to 6.0%). Prevalence of active-TB and severe post-TB lung changes was 3.6% (95% CI 2.6% to 4.8%) and 1.4% (95% CI 0.8% to 2.3%), respectively.InterpretationBased on radiological findings, we identified a wide variety of non-TB abnormalities during population-based TB screening. TB prevalence surveys and active case finding activities using mass CXR offer an opportunity to integrate disease screening efforts.FundingNational Institute for Health Research (IMPALA-grant reference 16/136/35).
- Subjects :
- Pulmonary and Respiratory Medicine
Male
medicine.medical_specialty
Tuberculosis
bronchiectasis
Population
wa_395
Disease
030204 cardiovascular system & hematology
Diagnosis, Differential
03 medical and health sciences
0302 clinical medicine
Disease Screening
Internal medicine
Surveys and Questionnaires
medicine
Prevalence
Humans
Mass Screening
030212 general & internal medicine
education
Tuberculosis, Pulmonary
Retrospective Studies
COPD
education.field_of_study
Bronchiectasis
business.industry
imaging/CT MRI etc
Middle Aged
medicine.disease
Kenya
emphysema
Cross-Sectional Studies
Radiological weapon
Female
Radiography, Thoracic
wf_200
Abnormality
business
COPD epidemiology
wf_225
Subjects
Details
- Language :
- English
- ISSN :
- 14683296 and 00406376
- Volume :
- 76
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Thorax
- Accession number :
- edsair.doi.dedup.....4a08905fb4c1caf4f205fb155a2e969a