Published: 27 January 2021

Authors: Brenda Nyambura Mungai, Elizabeth Joekes, Enos Masini, Angela Obasi, Veronica Manduku, Beatrice Mugi, Jane Ong’angò, Dickson Kirathe, Richard Kiplimo, Joseph Sitienei, Rose Oronje, Ben Morton, Stephen Bertel Squire, Peter MacPherson, IMPALA Consortium

Source: This abstract has been sourced from NZ Respiratory Research Review Issue 187


    Background The 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
    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 findings. A third reader resolved
    discrepancies. Prevalence and 95% CIs of abnormalities
    diagnosis were estimated.
    Findings Cardiomegaly was the most common nonTB 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.
    Interpretation Based 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.
    Funding National Institute for Health Research
    (IMPALA-grant reference 16/136/35).

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