Dataset Information

Chest Radiographic Patterns and the Transmission of Tuberculosis: Implications for Automated Systems.

ABSTRACT:

Background

Computer-aided detection to identify and diagnose pulmonary tuberculosis is being explored. While both cavitation on chest radiograph and smear-positivity on microscopy are independent risk factors for the infectiousness of pulmonary tuberculosis it is unknown which radiographic pattern, were it detectable, would provide the greatest public health benefit; i.e. reduced transmission. Herein we provide that evidence.

Objectives

1) to determine whether pulmonary tuberculosis in a high income, low incidence country is more likely to present with "typical" adult-type pulmonary tuberculosis radiographic features and 2) to determine whether those with "typical" radiographic features are more likely than those without such features to transmit the organism and/or cause secondary cases.

Methods

Over a three-year period beginning January 1, 2006 consecutive adults with smear-positive pulmonary tuberculosis in the Province of Alberta, Canada, were identified and their pre-treatment radiographs scored by three independent readers as "typical" (having an upper lung zone predominant infiltrate, with or without cavitation but no discernable adenopathy) or "atypical" (all others). Each patient's pre-treatment bacillary burden was carefully documented and, during a 30-month transmission window, each patient's transmission events were recorded. Mycobacteriology, radiology and transmission were compared in those with "typical" versus "atypical" radiographs.

Findings

A total of 97 smear-positive pulmonary tuberculosis cases were identified, 69 (71.1%) with and 28 (28.9%) without "typical" chest radiographs. "Typical" cases were more likely to have high bacillary burdens and cavitation (Odds Ratios and 95% Confidence Intervals: 2.75 [1.04-7.31] and 9.10 [2.51-32.94], respectively). Typical cases were also responsible for most transmission events-78% of tuberculin skin test conversions (p<0.002) and 95% of secondary cases in reported close contacts (p<0.01); 94% of secondary cases in "unreported" contacts (p<0.02).

Conclusion

As a group, smear-positive pulmonary tuberculosis patients with typical radiographic features constitute the greatest public health risk. This may have implications for automated detection systems.

SUBMITTER: Lau A

PROVIDER: S-EPMC4841548 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Publications

Chest Radiographic Patterns and the Transmission of Tuberculosis: Implications for Automated Systems.

Lau Angela A Barrie James J Winter Christopher C Elamy Abdel-Halim AH Tyrrell Gregory G Long Richard R

PloS one 20160422 4

<h4>Background</h4>Computer-aided detection to identify and diagnose pulmonary tuberculosis is being explored. While both cavitation on chest radiograph and smear-positivity on microscopy are independent risk factors for the infectiousness of pulmonary tuberculosis it is unknown which radiographic pattern, were it detectable, would provide the greatest public health benefit; i.e. reduced transmission. Herein we provide that evidence.<h4>Objectives</h4>1) to determine whether pulmonary tuberculos ...[more]

PMID: 27105337

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Dataset Information

Chest Radiographic Patterns and the Transmission of Tuberculosis: Implications for Automated Systems.

Background

Objectives

Methods

Findings

Conclusion

Publications

Chest Radiographic Patterns and the Transmission of Tuberculosis: Implications for Automated Systems.

Similar Datasets

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