Chest Infections |

Use of Chest X-rays in 22 High Tuberculosis Burden Countries FREE TO VIEW

Tripti Pande, BS; Madhukar Pai, MD; Claudia Denkinger, MD
Author and Funding Information

McGill University, Pointe-Claire, QC, Canada

Chest. 2015;148(4_MeetingAbstracts):141A. doi:10.1378/chest.2250163
Text Size: A A A
Published online


SESSION TITLE: Chest Infections Posters: Tuberculosis

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Chest x-rays (CXR) are commonly used in high tuberculosis (TB) burden countries (HBC) however their role and scope for TB diagnosis is poorly understood. Furthermore, with the developments of digital radiography and computer-aided diagnostic (CAD) tools there is increasing interest to exploit CXR as a triage test for TB screening.

METHODS: We conducted a survey of the 22 HBC to assess how chest x-rays are being used in these settings. A questionnaire was created and refined via a pilot study. One National TB Program (NTP) representative, 1-2 clinical practitioners, and 1 private sector representative were contacted in each of the 22 HBC. The majority response was used for discrepant results, and “inconsistent” was coded if no majority was reached.

RESULTS: We received 77 completed surveys, at least 2 responses per country. A majority of HBC (86%) use conventional (film-based) radiography. Only 2 countries (Bangladesh and China) reported usage of semi-digital radiography; no country used only digital radiography. 64% (14) of HBC reported usage of chest radiography in TB prevalence surveys. 37% (8) of HBC did not routinely provide CXR to patients with suspected TB out of which, 6 (75%) used CXR only for smear/Xpert negative patients. 37% HBC used GeneXpert only on patients with abnormal CXR. As a sole diagnostic tool for diagnosing pulmonary TB (PTB), 45% of HBC reported that CXRs were rarely (<10%) used, and 32% (7) reported they were sometimes (10-50%) used. Only 2 countries, Bangladesh and Cambodia, reported that CXRs were often (>50%) used as the sole diagnostic tool for PTB in the public sector. The median cost to NTPs for CXRs was $5 USD (interquartile range 8-8.5). 41% countries used CXRs as an integral component of national guidelines to diagnose PTB.

CONCLUSIONS: Chest x-rays are widely used in the 22 HBC, mostly for smear/Xpert negative patients and in TB prevalence surveys. Conventional (film-based) CXR is still the dominant technology, and some countries use it as the sole diagnostic technique for PTB.

CLINICAL IMPLICATIONS: This survey suggests that CXRs continue to be a prominent tool for PTB screening in the 22 HBC.

DISCLOSURE: Tripti Pande: Consultant fee, speaker bureau, advisory committee, etc.: I will be receiving a payment from FIND diagnostics, the official document has been signed. The following authors have nothing to disclose: Madhukar Pai, Claudia Denkinger

No Product/Research Disclosure Information




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Mycobacterial infections.
New York State Department of Health | 6/20/2008
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543