Berteloot L., Marcy O., Nguyen B., Ung V., Tejiokem M., Nacro B., Goyet S., Dim B., Blanche S., Borand L., Msellati Philippe, Delacourt C., ANRS 12229 PAANTHER 01 Study Group. (2018). Value of chest X-ray in TB diagnosis in HIV-infected children living in resource-limited countries : the ANRS 12229-PAANTHER 01 study. International Journal of Tuberculosis and Lung Disease, 22 (8), p. 844-850 +5 p. ISSN 1027-3719.
Titre du document
Value of chest X-ray in TB diagnosis in HIV-infected children living in resource-limited countries : the ANRS 12229-PAANTHER 01 study
Année de publication
2018
Auteurs
Berteloot L., Marcy O., Nguyen B., Ung V., Tejiokem M., Nacro B., Goyet S., Dim B., Blanche S., Borand L., Msellati Philippe, Delacourt C., ANRS 12229 PAANTHER 01 Study Group
Source
International Journal of Tuberculosis and Lung Disease, 2018,
22 (8), p. 844-850 +5 p. ISSN 1027-3719
OBJECTIVE: To evaluate inter-reader agreement and diagnostic accuracy of chest radiography (CXR) in the diagnosis of tuberculosis (TB) in children with human immunodeficiency virus (HIV) infection. DESIGN: HIV-infected children with clinically suspected TB were enrolled in a prospective study conducted in Burkina Faso, Cambodia, Cameroon and Viet Nam from April 2010 to December 2014. Three readers-a local radiologist, a paediatric pulmonologist and a paediatric radiologist-independently reviewed the CXRs. Inter-reader agreement was then assessed using the kappa coefficient. Diagnostic accuracy of CXR was assessed in culture-confirmed cases and controls. RESULTS: A total of 403 children (median age 7.3 years, interquartile range 3.5-9.7; 49.6% males) were enrolled. Inter-reader agreement was as follows: between local radiologist and paediatric pulmonologist, kappa = 0.36 (95%CI 0.27-0.45); local radiologist and paediatric radiologist, kappa = 0.16 (95%CI 0.08-0.24); and paediatric pulmonologist and paediatric radiologist, kappa = 0.30 (95%CI 0.21-0.40). Among 51 cases and 151 controls, after a consensus, CXR had a sensitivity of 71.4% (95%CI 58.8-84.1) and a specificity of 50.0% (95%CI 41.9-58.1). Alveolar opacities and enlarged lymph nodes on CXR had limited specificity for TB (64.7% and 70.2%, respectively). Miliary and/or nodular opacities patterns on CXR were more specific to TB (specificity 94.3%). CONCLUSION: CXR showed poor-to-fair inter-reader agreement and limited diagnostic accuracy for TB in HIV-infected children, likely due to comorbidities. Radiological criteria for this specific population require further investigation.
Plan de classement
Santé : généralités [050]
;
Entomologie médicale / Parasitologie / Virologie [052]
Description Géographique
BURKINA FASO ; CAMBODGE ; CAMEROUN ; VIET NAM
Localisation
Fonds IRD [F B010073209]
Identifiant IRD
fdi:010073209
