SETTING: Francistown and Gaborone, Botswana. OBJECTIVE: Chest radiography is used to screen for tuberculosis (TB) in asymptomatic persons living with the human immunodeficiency virus (PLWH) seeking isoniazid preventive therapy (IPT). We describe radiographic features in PLWH in a TB-endemic setting and identify features associated with TB disease. DESIGN: Asymptomatic PLWH seeking IPT under program conditions for a clinical trial between 2004 and 2006 received chest radiographs (CXRs) that were read using the standardized Chest Radiograph Reading and Recording System (CRRS). Clinical characteristics, including TB disease, were compared with the radiographic findings. RESULTS: From 2732 screening CXRs, 183 had one or more abnormalities and were scored using CRRS, with 42% having infiltrates (36% upper lobes), 35% parenchymal fibrosis and 32% adenopathy. TB disease status was determined in 129 (70%) PLWH, of whom 22 (17%) had TB disease. TB disease was associated with upper lobe infiltrates (relative risk [RR] 3.0, 95%CI 1.5-6.2) and mediastinal adenopathy (RR 3.9, 95%CI 1.8-8.4). The sensitivity and specificity of either upper lobe infiltrates or mediastinal lymphadenopathy for TB disease were respectively 64% and 82%. CONCLUSION: A combination of CXR features was useful for predicting TB disease in asymptomatic PLWH. CRRS should be used more frequently in similar studies.
SETTING: Francistown and Gaborone, Botswana. OBJECTIVE: Chest radiography is used to screen for tuberculosis (TB) in asymptomatic persons living with the human immunodeficiency virus (PLWH) seeking isoniazid preventive therapy (IPT). We describe radiographic features in PLWH in a TB-endemic setting and identify features associated with TB disease. DESIGN: Asymptomatic PLWH seeking IPT under program conditions for a clinical trial between 2004 and 2006 received chest radiographs (CXRs) that were read using the standardized Chest Radiograph Reading and Recording System (CRRS). Clinical characteristics, including TB disease, were compared with the radiographic findings. RESULTS: From 2732 screening CXRs, 183 had one or more abnormalities and were scored using CRRS, with 42% having infiltrates (36% upper lobes), 35% parenchymal fibrosis and 32% adenopathy. TB disease status was determined in 129 (70%) PLWH, of whom 22 (17%) had TB disease. TB disease was associated with upper lobe infiltrates (relative risk [RR] 3.0, 95%CI 1.5-6.2) and mediastinal adenopathy (RR 3.9, 95%CI 1.8-8.4). The sensitivity and specificity of either upper lobe infiltrates or mediastinal lymphadenopathy for TB disease were respectively 64% and 82%. CONCLUSION: A combination of CXR features was useful for predicting TB disease in asymptomatic PLWH. CRRS should be used more frequently in similar studies.
Authors: C Yoon; L H Chaisson; S M Patel; I E Allen; P K Drain; D Wilson; A Cattamanchi Journal: Int J Tuberc Lung Dis Date: 2017-09-01 Impact factor: 2.373
Authors: Catriona J Waitt; Elizabeth C Joekes; Natasha Jesudason; Peter I Waitt; Patrick Goodson; Ganizani Likumbo; Samuel Kampondeni; E Brian Faragher; S Bertel Squire Journal: Eur Radiol Date: 2013-05-08 Impact factor: 5.315
Authors: Lancelot M Pinto; Keertan Dheda; Grant Theron; Brian Allwood; Gregory Calligaro; Richard van Zyl-Smit; Jonathan Peter; Kevin Schwartzman; Dick Menzies; Eric Bateman; Madhukar Pai; Rodney Dawson Journal: PLoS One Date: 2013-01-18 Impact factor: 3.240
Authors: German Henostroza; Jennifer B Harris; Nzali Kancheya; Venerandah Nhandu; Stable Besa; Robert Musopole; Annika Krüüner; Chisela Chileshe; Ian J Dunn; Stewart E Reid Journal: BMC Infect Dis Date: 2016-03-23 Impact factor: 3.090
Authors: Patrick G T Cudahy; Rodney Dawson; Brian W Allwood; Gary Maartens; Douglas Wilson Journal: Open Forum Infect Dis Date: 2017-06-17 Impact factor: 3.835