scholarly journals ‘If not TB, what could it be?’ Chest X-ray findings from the 2016 Kenya Tuberculosis Prevalence Survey

Thorax ◽  
2021 ◽  
pp. thoraxjnl-2020-216123
Author(s):  
Brenda Nyambura Mungai ◽  
Elizabeth Joekes ◽  
Enos Masini ◽  
Angela Obasi ◽  
Veronica Manduku ◽  
...  
Keyword(s):  
Population Based ◽  
Sub Saharan Africa ◽  
Radiological Findings ◽  
Prevalence Survey ◽  
X Ray ◽  
Chest X Ray ◽  
Sub Saharan ◽  
Significant Disease ◽  
Tuberculosis Prevalence ◽  
Missed Opportunity

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).

scholarly journals Characteristics and outcomes of admitted patients infected with SARS-CoV-2 in Uganda

2020 ◽  
Vol 7 (1) ◽  
pp. e000646 ◽  
Author(s):  
Bruce Kirenga ◽  
Winters Muttamba ◽  
Alex Kayongo ◽  
Christopher Nsereko ◽  
Trishul Siddharthan ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Sub Saharan Africa ◽  
Detailed Data ◽  
X Ray ◽  
Mild Disease ◽  
Clinical Recovery ◽  
Abnormal Chest ◽  
Chest X Ray ◽  
Sub Saharan ◽  
Muscle Ache

RationaleDetailed data on the characteristics and outcomes of patients with COVID-19 in sub-Saharan Africa are limited.ObjectiveWe determined the clinical characteristics and treatment outcomes of patients diagnosed with COVID-19 in Uganda.MeasurementsAs of the 16 May 2020, a total of 203 cases had been confirmed. We report on the first 56 patients; 29 received hydroxychloroquine (HCQ) and 27 did not. Endpoints included admission to intensive care, mechanical ventilation or death during hospitalisation.Main resultsThe median age was 34.2 years; 67.9% were male; and 14.6% were <18 years. Up 57.1% of the patients were asymptomatic. The most common symptoms were fever (21.4%), cough (19.6%), rhinorrhea (16.1%), headache (12.5%), muscle ache (7.1%) and fatigue (7.1%). Rates of comorbidities were 10.7% (pre-existing hypertension), 10.7% (diabetes) and 7.1% (HIV), Body Mass Index (BMI) of ≥30 36.6%. 37.0% had a blood pressure (BP) of >130/90 mm Hg, and 27.8% had BP of >140/90 mm Hg. Laboratory derangements were leucopenia (10.6%), lymphopenia (11.1%) and thrombocytopenia (26.3%). Abnormal chest X-ray was observed in 14.3%. No patients reached the primary endpoint. Time to clinical recovery was shorter among patients who received HCQ, but this difference did not reach statistical significance.ConclusionMost of the patients with COVID-19 presented with mild disease and exhibited a clinical trajectory not similar to other countries. Outcomes did not differ by HCQ treatment status in line with other concluded studies on the benefit of using HCQ in the treatment of COVID-19.

Yield of interview screening and chest X-ray abnormalities in a tuberculosis prevalence survey

2012 ◽  
Vol 16 (6) ◽  
pp. 762-767 ◽  
Author(s):  
N. B. Hoa ◽  
F. G. J. Cobelens ◽  
D. N. Sy ◽  
N. V. Nhung ◽  
M. W. Borgdorff ◽  
...  
Keyword(s):  
Prevalence Survey ◽  
X Ray ◽  
Chest X Ray ◽  
Tuberculosis Prevalence

scholarly journals It's not TB but what could it be? Abnormalities on chest X-rays taken during the Kenya National Tuberculosis Prevalence Survey

2020 ◽  
Author(s):  
Brenda Nyambura Mungai ◽  
Elizabeth Joekes ◽  
Enos Masini ◽  
Angela Obasi ◽  
Veronica Manduku ◽  
...  
Keyword(s):  
Survey Methods ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Radiological Diagnosis ◽  
Chronic Obstructive ◽  
X Rays ◽  
Prevalence Survey ◽  
Obstructive Pulmonary Disease ◽  
National Tuberculosis ◽  
Sub Saharan

Background: The prevalence of diseases other than tuberculosis (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 quantify and characterise non-TB abnormalities identified by TB-focused CXR screening during the 2016 Kenya National TB prevalence survey. Methods: We 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 diagnosis. A third reader resolved discrepancies. Prevalence and 95% confidence intervals of abnormalities diagnosis were estimated. Findings: Cardiomegaly was the most common non-TB abnormality at 259/1123 (23∙1%, 95% CI 20∙6%-25∙6%), while cardiomegaly with features of cardiac failure occurred in 17/1123 (1∙5 %, 95% CI 0.9%-2∙4%). We also identified chronic pulmonary pathology including suspected chronic obstructive pulmonary disease in 3∙2% (95% CI 2∙3%- 4∙4%) and non-specific patterns in 4∙6% (95% CI 3∙5%- 6∙0%). Prevalence of active-TB and severe post-TB lung changes was 3∙6% (95% CI 2∙6%- 4∙8%) and 1∙4% (95% CI 0∙8%- 2∙3%) respectively. Interpretation: Based on radiological diagnosis, we identified a wide variety of non-TB diagnoses during population-based TB screening. TB prevalence surveys and active case finding activities using mass CXR offer an opportunity to integrate disease screening efforts. Funding National Institute for Health Research (IMPALA-grant reference 16/136/35).

Chest X-ray in Sarcoidosis: The Association of Age, Gender, and Ethnicity with Different Radiological Findings

2018 ◽  
Vol 13 (4) ◽  
pp. 241-246 ◽  
Author(s):  
Saif Aldeen AlRyalat ◽  
Mohammad Al-Essa ◽  
Rawan Ghazal ◽  
Enas Abusalim ◽  
Dia Mobaideen ◽  
...  
Keyword(s):  
Radiological Findings ◽  
X Ray ◽  
Chest X Ray

scholarly journals Cervical cancer in Sub‐Saharan Africa: a multinational population‐based cohort study on patterns and guideline adherence of care

2021 ◽  
Author(s):  
Mirko Griesel ◽  
Tobias P Seraphin ◽  
Nikolaus CS Mezger ◽  
Lucia Hämmerl ◽  
Jana Feuchtner ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cohort Study ◽  
Guideline Adherence ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Sub Saharan

scholarly journals Caffeine for the care of preterm infants in sub-Saharan Africa: a missed opportunity?

2021 ◽  
Vol 6 (12) ◽  
pp. e007682
Author(s):  
Helen M Nabwera ◽  
Osayame A Ekhaguere ◽  
Haresh Kirpalani ◽  
Kathy Burgoine ◽  
Chinyere V Ezeaka ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
Missed Opportunity

scholarly journals Cohort profile: The Chikwawa lung health cohort; a population-based observational non-communicable respiratory disease study in Malawi

2020 ◽  
Author(s):  
Martin Njoroge ◽  
Sarah Rylance ◽  
Rebecca Nightingale ◽  
Stephen Gordon ◽  
Kevin Mortimer ◽  
...  
Keyword(s):  
Health Economic ◽  
Lung Function ◽  
Low Income ◽  
Respiratory Symptoms ◽  
Population Based ◽  
Sub Saharan Africa ◽  
Rural Setting ◽  
Sub Saharan ◽  
Lung Health

AbstractPurposeThe Chikwawa lung health cohort was established in rural Malawi in 2014 to prospectively determine the prevalence and causes of lung disease amongst the general population of adults living in a low-income rural setting in Sub-Saharan Africa.ParticipantsA total of 1481 participants were randomly identified and recruited in 2014 for the baseline study. We collected data on demographic, socio-economic status, respiratory symptoms and potentially relevant exposures such as smoking, household fuels, environmental exposures, occupational history/exposures, dietary intake, healthcare utilization, cost (medication, outpatient visits and inpatient admissions) and productivity losses. Spirometry was performed to assess lung function. At baseline, 56.9% of the participants were female, a mean age of 43.8 (SD:17.8) and mean body mass index (BMI) of 21.6 Kg/m2 (SD: 3.46)Findings to dateCurrently, two studies have been published. The first reported the prevalence of chronic respiratory symptoms (13.6%, 95% confidence interval [CI], 11.9 – 15.4), spirometric obstruction (8.7%, 95% CI, 7.0 – 10.7), and spirometric restriction (34.8%, 95% CI, 31.7 – 38.0). The second reported annual decline in forced expiratory volume in one second [FEV1] of 30.9mL/year (95% CI: 21.6 to 40.1) and forced vital capacity [FVC] by 38.3 mL/year (95% CI: 28.5 to 48.1).Future plansThe ongoing current phase of follow-up will determine the annual rate of decline in lung function as measured through spirometry, and relate this to morbidity, mortality and economic cost of airflow obstruction and restriction. Population-based mathematical models will be developed driven by the empirical data from the cohort and national population data for Malawi to assess the effects of interventions and programmes to address the lung burden in Malawi. The present follow-up study started in 2019.Strengths and limitations of this studyThis is an original cohort study comprising adults randomly identified in a low-income Sub-Saharan African Setting.The repeated follow up of the cohort has included objective measures of lung function.The cohort has had high rates of case ascertainment that include verbal autopsies.The study will include an analysis of the health economic consequences of rate of change of lung function and health economic modelling of impact of lung diseases and potential interventions that could be adopted.A main limitation of our study is the systematic bias may be introduced through the self-selection of the participants who agreed to take part in the study to date and the migration of individuals from Chikwawa.

Retrospective Review of Clinical and Chest X-Ray Findings in Children Admitted to a Community Hospital for Respiratory Syncytial Virus Infection

2018 ◽  
Vol 57 (14) ◽  
pp. 1686-1692 ◽  
Author(s):  
Denver Niles ◽  
Brett Larsen ◽  
Arvind Balaji ◽  
Dana Delaney ◽  
Elizabeth Campos ◽  
...  
Keyword(s):  
Respiratory Syncytial Virus ◽  
Pediatric Intensive Care ◽  
Clinical Findings ◽  
X Rays ◽  
Radiological Findings ◽  
X Ray ◽  
Severe Group ◽  
Rsv Infection ◽  
Chest X Ray ◽  
Syncytial Virus

Introduction. We performed a retrospective study to evaluate demographics, clinical course, outcome, and radiological findings of children with respiratory syncytial virus (RSV) infection. Methods. Four hundred patients admitted between October 2013 and May 2016 were enrolled. Clinical and radiographic trends were evaluated for association with severity of RSV presentation. Severity was defined as hospitalization >2 days, pediatric intensive care unit admission, or need for mechanical ventilation. Results. Common clinical findings included fever (78.5%), coughing (97%), rhinorrhea/congestion (93%), and hypoxia (44.8%). Hypoxia was seen in 64.7% of the severe group compared with 32.0% in the nonsevere group ( P < .001). Airspace opacification was seen in 49.2% of chest X-rays of the severe group compared with 26.4% in the nonsevere group ( P < .001). Conclusion. Higher incidence of hypoxia or airspace opacification on chest X-ray may be predictors of poorer outcomes for patients with RSV infection.

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