Symptom and digital chest X-ray TB screening in South African prisons: yield and cost-effectiveness

2020 ◽  
Vol 24 (3) ◽  
pp. 295-302 ◽  
Author(s):  
H-Y. Kim ◽  
V. Zishiri ◽  
L. Page-Shipp ◽  
S. Makgopa ◽  
G. J. Churchyard ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
South African ◽  
Correctional Facilities ◽  
Cost Effectiveness Ratio ◽  
X Ray ◽  
Symptom Screening ◽  
Night Sweats ◽  
Digital Chest ◽  
Chest X Ray ◽  
Optimal Approach

BACKGROUND: Correctional inmates are at a high risk of tuberculosis (TB). The optimal approach to screening this population is unclear.METHODS: We retrospectively reviewed records from TB screening in 64 correctional facilities in South Africa between January 2015 and July 2016. Inmates received symptom screening (any of cough, fever, weight loss, or night sweats) combined with digital chest X-ray (CXR), when available. CXRs were assessed as ‘abnormal' or with no abnormalities. Inmates with either a symptom or an ‘abnormal' CXR were asked to provide a single spot sputum for Xpert® MTB/RIF testing. We estimated the incremental cost-effectiveness ratio (ICER) per additional TB case detected using CXR screening among asymptomatic inmates.RESULTS: Of 61 580 inmates, CXR screening was available for 41 852. Of these, 19 711 (47.1%) had TB symptoms. Among 22 141 inmates without symptoms, 1939/19 783 (9.8%) had an abnormal CXR, and 8 (1.2%) were Xpert-positive among those with Xpert tests done. Of 14 942 who received symptom screening only and had symptoms, 84% (12 616) had an Xpert result, and 105 (0.8%) were positive. The ICER for CXR screening was US$22 278.CONCLUSION: Having CXR in addition to symptom screening increased yield but added considerable cost. A major limitation of screening was the low specificity of the symptom screen.

Digital Chest X-ray with Computer-aided Detection for TB Screening within Correctional Facilities

2021 ◽  
Author(s):  
Kavindhran Velen ◽  
Farzana Sathar ◽  
Christopher J Hoffmann ◽  
Harry Hausler ◽  
Amanda Fononda ◽  
...  
Keyword(s):  
Correctional Facilities ◽  
Computer Aided Detection ◽  
X Ray ◽  
Computer Aided ◽  
Digital Chest ◽  
Chest X Ray

Prevalence and risk factors of tuberculosis disease in South African correctional facilities in 2015

2019 ◽  
Vol 23 (11) ◽  
pp. 1198-1204
Author(s):  
A. M. Jordan ◽  
L. J. Podewils ◽  
K. G. Castro ◽  
V. Zishiri ◽  
S. Charalambous
Keyword(s):  
Risk Factors ◽  
South African ◽  
Screening Program ◽  
Computer Assisted ◽  
Correctional Facilities ◽  
Prevalence Estimates ◽  
Screening Coverage ◽  
Digital Chest ◽  
Chest X Ray ◽  
Using Data

SETTING: Sixteen South African correctional facilities.OBJECTIVE: To determine the prevalence of and risk factors for tuberculosis (TB) in South African correctional facilities using data collected during a TB screening program in South African correctional facilities in 2015.DESIGN: Inmates in 16 South African correctional facilities were screened for TB from January to December 2015. Inmates reporting ≥1 TB symptom or having an abnormal computer-assisted digital chest X-ray (CXR) provided sputum. Abnormal CXRs were interpreted by a radiologist. Sputum was tested for Mycobacterium tuberculosis using Xpert® MTB/RIF. Data from 16 South African correctional facilities were used in regression analysis, and prevalence estimates calculated for 12 South African correctional facilities with >30% screening coverage.RESULTS: In 12 South African correctional facilities included in the prevalence estimates, 837 inmates had TB disease (2653/100 000) as indicated by current TB treatment or screening-identified TB by radiologist or Xpert. Previous TB was associated with increased odds of screening-identified TB in HIV-positive inmates (OR 4.3, 95%CI 2.5–7.3). For HIV-negative inmates, previous TB (adjusted OR [aOR] 4.9, 95%CI 1.7–14.1) and self-reported symptoms vs. none (1 symptom, aOR 8.8, 95%CI 1.2–67.7; >2 symptoms, aOR 21.7, 95%CI 3.0–158.8) were independently associated with increased odds of screening-identified TB.CONCLUSIONS: Routine TB screening, including CXR, is needed in South African correctional facilities to identify and refer inmates with active TB.

scholarly journals Cost-effectiveness of point-of-care digital chest-x-ray in HIV patients with pulmonary mycobacterial infections in Nigeria

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Gambo Aliyu ◽  
Samer S El-Kamary ◽  
Alash’le Abimiku ◽  
Laura Hungerford ◽  
Joshua Obasanya ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Point Of Care ◽  
Hiv Patients ◽  
Mycobacterial Infections ◽  
X Ray ◽  
Digital Chest ◽  
Chest X Ray

scholarly journals Increased mRNA Expression of Key Cytokines Among Suspected Cases of Pneumocystis Jirovecii Infection

2020 ◽  
Author(s):  
Mohammad Y. Alshahrani ◽  
Mohammed Alfaifi ◽  
Mesfer Al Shahrani ◽  
Abdulaziz S. Alshahrani ◽  
Ali G. Alkhathami ◽  
...  
Keyword(s):  
Weight Loss ◽  
Mrna Expression ◽  
Clinical Manifestations ◽  
Pneumocystis Pneumonia ◽  
Pneumocystis Jirovecii ◽  
Rt Pcr ◽  
Cross Sectional ◽  
X Ray ◽  
Night Sweats ◽  
Chest X Ray

Abstract Background: Pneumocystis pneumonia (PCP) is a fatal infectious disease caused by Pneumocystis jirovecii (PJP). The major factor relevant to morbidity and mortality seems to be the host inflammatory reaction. The objective of this study was to evaluate the role of IL-2, IL-4, IL-10, and IL-13 cytokines mRNA expression among suspected P. jirovecii infection.Methods: This was a cross-sectional analytic study undertaken in Aseer region, Saudi Arabia. A 100 suspected PCP cases and a 100 healthy controls were included in the study. Basic clinical manifestations, radiological findings, microbiological and immunological findings were extracted from the hospital records from January 2019 to August 2019, Pneumocystis detection was done by the immune-fluorescent staining (IFAT, Gomorimethanamine silver staining (GMSS), Giemsa staining, Toluidine blue O (TBO), and Pneumocystis RT-PCR. Results: Increased more than 5 fold, 3 fold, 4 fold, and 7 fold of IL-2, IL-4, IL-10, and IL-13 mRNA expression were observed in PCP cases compared to control. Higher expression of IL-2 mRNA was connected with crept, wheezing and chest X-ray findings like central perihilar infiltrates, patchy infiltrates, consolidation, hilar lymphadenopathy, pneumothorax, pleural effusion which showed higher expression compared to counterpart (p<0.0001). Higher expression of IL-4 mRNA was found to be significantly associated with the weight loss (p=0.002), dyspnea (p=0.003), crept (p=0.01), and chest X-ray findings (p<0.0001). Significantly increased expression of IL-10 mRNA was observed to be associated with weight loss, dyspnea, night sweats, wheezing, and different findings of chest X-ray compared to their counterparts, whereas, IL-13 mRNA was observed with cases with fever. Suspected cases of PCP confirmed positive by IFTA with higher IL-2, IL-4 and IL-10 mRNA expression compared to negative cases. RT-PCR confirmed PCP cases had significantly higher expression of IL-2, IL-4 and IL-10 as well as IL-13 mRNA compared to negative cases. Positive detected cases by GMSS showed higher IL-2, IL-10 mRNA expression, while Giemsa showed only higher IL-4 mRNA expression compared to negatives cases. Conclusion: Confirmed cases of P. jirovecii showed higher IL-2, IL-4, IL-10, and IL-13 mRNA expression comparatively to negative cases. Increased expression of cytokines may be indicative of infection severity and could help in patients’ management.

scholarly journals Automated chest radiograph diagnosis: A Twofer for Tuberculosis and Covid-19

2020 ◽  
Author(s):  
Mitushi Verma ◽  
Deepak Patkar ◽  
Madhura Ingalharikar ◽  
Amit Kharat ◽  
Pranav Ajmera ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
X Ray ◽  
Recent Onset ◽  
Radiology Reports ◽  
Fast Spreading ◽  
Digital Chest ◽  
Chest X Ray ◽  
End To End ◽  
The Times

AbstractCoronavirus disease (Covid 19) and Tuberculosis (TB) are two challenges the world is facing. TB is a pandemic which has challenged mankind for ages and Covid 19 is a recent onset fast spreading pandemic. We study these two conditions with focus on Artificial Intelligence (AI) based imaging, the role of digital chest x-ray and utility of end to end platform to improve turnaround times. Using artificial intelligence assisted technology for triage and creation of structured radiology reports using an end to end platform can ensure quick diagnosis. Changing dynamics of TB screening in the times of Covid 19 pandemic have resulted in bottlenecks for TB diagnosis. The paper tries to outline two types of use cases, one is COVID-19 screening in a hospital-based scenario and the other is TB screening project in mobile van setting and discusses the learning of these models which have both used AI for prescreening and generating structured radiology reports.

Cost-Effectiveness of Chest X-Ray Follow-Up of Patients Treated for Seminoma of the Testis

1986 ◽  
Vol 72 (4) ◽  
pp. 405-408 ◽  
Author(s):  
Stefano Ciatto ◽  
Luca Cionini ◽  
Paolo Pacini
Keyword(s):  
Cost Effectiveness ◽  
Detection Rate ◽  
Primary Treatment ◽  
Stage I ◽  
First Year ◽  
Consecutive Series ◽  
X Ray ◽  
Chest X Ray ◽  
One Year

The authors report on a consecutive series of 253 cases of seminoma of the testis followed with periodic chest X-ray examinations from a minimum of three to a maximum of 27 years. The detection rate of asymptomatic intrathoracic metastases (ITM) was considered together with the costs of the follow-up procedure. Chest X-ray follow-up is not advisable beyond one year from primary treatment, since most (14 of 18) ITM occur in the first year, the detection rate of ITM beyond this date is too low (0.11% patients/year), and the related costs are too high (over $ 130,000 per ITM detected). Chest X-ray follow-up is questionable even in the first year after primary treatment for Stage I cases because of the low detection rate (1.38% patients/year) and the high costs (over $ 14,000 per ITM detected), whereas it appears to be opportune in Stages IIA and IIB.

scholarly journals Lung X-ray Segmentation using Deep Convolutional Neural Networks on Contrast-Enhanced Binarized Images

Mathematics ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 545 ◽  
Author(s):  
Hsin-Jui Chen ◽  
Shanq-Jang Ruan ◽  
Sha-Wo Huang ◽  
Yan-Tsung Peng
Keyword(s):  
Neural Networks ◽  
Convolutional Neural Networks ◽  
Deep Convolutional Neural Networks ◽  
X Ray ◽  
Processing Approach ◽  
Segmentation Accuracy ◽  
Enhancement Method ◽  
Digital Chest ◽  
Chest X Ray ◽  
Model Training

Automatically locating the lung regions effectively and efficiently in digital chest X-ray (CXR) images is important in computer-aided diagnosis. In this paper, we propose an adaptive pre-processing approach for segmenting the lung regions from CXR images using convolutional neural networks-based (CNN-based) architectures. It is comprised of three steps. First, a contrast enhancement method specifically designed for CXR images is adopted. Second, adaptive image binarization is applied to CXR images to separate the image foreground and background. Third, CNN-based architectures are trained on the binarized images for image segmentation. The experimental results show that the proposed pre-processing approach is applicable and effective to various CNN-based architectures and can achieve comparable segmentation accuracy to that of state-of-the-art methods while greatly expediting the model training by up to 20.74 % and reducing storage space for CRX image datasets by down to 94.6 % on average.

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