Browsing by Author "Mubiru, Joseph"

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    Accuracy and Incremental Yield of the Chest X-Ray in Screening for Tuberculosis in Uganda: A Cross-Sectional Study
    (Tuberculosis research and treatment, 2021) Nalunjogi, Joanitah; Mugabe, Frank; Najjingo, Irene; Lusiba, Pastan; Olweny, Francis; Mubiru, Joseph; Kayongo, Edward; Sekibira, Rogers; Katamba, Achilles; Kirenga, Bruce
    TheWHOEND TB strategy requires ≥90% case detection to combat tuberculosis (TB). Increased TB case detection requires a more sensitive and specific screening tool. Currently, the symptoms recommended for screening TB have been found to be suboptimal since up to 44% of individuals with TB are asymptomatic. The chest X-ray (CXR) as a screening tool for pulmonary TB was evaluated in this study, as well as its incremental yield in TB diagnosis using a cross-sectional study involving secondary analysis of data of 4512 consented/assented participants ≥15 years who participated in the Uganda National TB prevalence survey between 2014 and 2015. Participants with a cough ≥2 weeks, fever, weight loss, and night sweats screened positive for TB using the symptoms screening method, while participants with a TB defining abnormality on CXR screened positive for TB by the CXR screening method. The Löwenstein-Jensen (LJ) culture was used as a gold standard for TB diagnosis. The CXR had 93% sensitivity and 65% specificity compared to LJ culture results, while symptoms had 76% sensitivity and 31% specificity. The screening algorithm involving the CXR in addition to symptoms led to a 38% increment in the yield of diagnosed tuberculosis. The number needed to screen using the CXR and symptoms screening algorithm was 32 compared to 45 when the symptoms are used alone. Therefore, the CXR in combination with symptoms is a good TB screening tool and increases the yield of diagnosed TB.
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    Accuracy of the chest x-ray in screening for tuberculosis in Uganda: A cross-sectional study.
    (Research Square, 2020) Nalunjogi, Joanitah; Mugabe, Frank; Najjingo, Irene; Lusiba, Pastan; Olweny, Francis; Mubiru, Joseph; Kayongo, Edward; Sekibira, Rogers; Katamba, Achilles; Kirenga, Bruce
    The WHO END TB strategy requires ≥90% case detection to combat tuberculosis (TB). Increased TB case detection requires a more sensitive and specific screening tool. Currently, the symptoms recommended for screening TB have been found to be sub-optimal. CXR as a screening tool for pulmonary TB was evaluated in this study, as well as factors related to its false positive results. METHODS: A cross sectional study of 4441 records of consented/assented participants ≥15 years. Participants with a cough ≥2 weeks and/or any abnormality in the lung on CXR were included in the study. Löwenstein-Jensen (LJ) culture was used as the gold standard. The CXR were categorised as Abnormal meaning presence of any CXR abnormality suggestive of active tuberculosis. Symptoms were categorised as abnormal meaning presence of any of cough ≥ 2 weeks, fever, weightloss or night sweats. RESULTS: The CXR had sensitivity 93%, specificity 65% compared to culture results while symptoms had sensitivity 76% and specificity 31%. The adjusted prevalence ratio (APR) of a false positive CXR result increased with age categories (years); 45 - 54, APR 1.18 (1.08, 1.29), 55 – 64 APR 1.18 (1.09, 1.29), 65+years APR 1.2 (1.10, 1.30).The APR was 0.93 (0.90, 0.96) among males and 0.86 (0.79, 0.93) among HIV positive individuals. CONCLUSIONS: The CXR is a fair tuberculosis screening tool and performed better than symptoms in Uganda.