Accuracy of the chest x-ray in screening for tuberculosis in Uganda: A cross-sectional study.
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Research Square
Abstract
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.
Description
Keywords
CXR, Symptoms, Accuracy, Screening, Tuberculosis, Chest radiograph
Citation
Nalunjogi, J., Mugabe, F., Najjingo, I., Lusiba, P., Olweny, F., Mubiru, J., ... & Kirenga, B. (2020). Accuracy of the chest x-ray in screening for tuberculosis in Uganda: A cross-sectional study. https://doi.org/10.21203/rs.3.rs-37900/v1