Significance of Chest x-rays in the diagnosis of smear negative chest x-rays
Background of the study
Tuberculosis has reemerged as the leading cause of morbidity and mortality in Kenya Infection rate is highest between 15-44 years with a nine fold increase since early 90’s due to the HIV/AIDS pandemic. The HIV infected have an increased incidence with a majority presenting with smear negative PTB
Hypothesis
Chest x-ray in itself is not an effective method of diagnosing smear negative pulmonary tuberculosis in H.I.V positive patients
Broad Objective To assess the utility of the radiological manifestations of pulmonary tuberculosis in HIV infected smear negative patients and how they compare with the culture outcome.
Study site
AMPATH MTRH TB clinic, AMPATH records office, AMPATH TB diagnostic labs.
Study design
Retrospective study.
Sampling techniques
Systematic random sampling
Study population
A total of 70 HIV positive patients were analyzed for their AFB smear, culture from sputum and chest X-ray results. Sputum smear negative cases having findings consistent with TB on chest x-ray were matched with culture results for the final diagnosis. Sensitivity, specificity, negative and positive predictive values of the chest x-ray was determined in smear negative cases.
Data management, analysis and presentation
Secondary data was collected from AMPATH MTRH records office. Each data sheet was given a serial number and each variable given a code. The data was analyzed using SPSS and manual computation. The results were presented in tables, graphs and ratios.
Results
The most common radiological manifestation on chest x-ray were pulmonary infiltrates which represented 48% and 25% reported as normal. Of the 70 patients who were sampled 52 were culture negative which represents 74% while the remaining 18 (26%) were culture positive. The sensitivity and specificity of Chest x-rays in sputum smear negative cases was 72% and 23% respectively. The positive predictive value was 32.5% and the negative predictive value
Tuberculosis has reemerged as the leading cause of morbidity and mortality in Kenya Infection rate is highest between 15-44 years with a nine fold increase since early 90’s due to the HIV/AIDS pandemic. The HIV infected have an increased incidence with a majority presenting with smear negative PTB
Hypothesis
Chest x-ray in itself is not an effective method of diagnosing smear negative pulmonary tuberculosis in H.I.V positive patients
Broad Objective To assess the utility of the radiological manifestations of pulmonary tuberculosis in HIV infected smear negative patients and how they compare with the culture outcome.
Study site
AMPATH MTRH TB clinic, AMPATH records office, AMPATH TB diagnostic labs.
Study design
Retrospective study.
Sampling techniques
Systematic random sampling
Study population
A total of 70 HIV positive patients were analyzed for their AFB smear, culture from sputum and chest X-ray results. Sputum smear negative cases having findings consistent with TB on chest x-ray were matched with culture results for the final diagnosis. Sensitivity, specificity, negative and positive predictive values of the chest x-ray was determined in smear negative cases.
Data management, analysis and presentation
Secondary data was collected from AMPATH MTRH records office. Each data sheet was given a serial number and each variable given a code. The data was analyzed using SPSS and manual computation. The results were presented in tables, graphs and ratios.
Results
The most common radiological manifestation on chest x-ray were pulmonary infiltrates which represented 48% and 25% reported as normal. Of the 70 patients who were sampled 52 were culture negative which represents 74% while the remaining 18 (26%) were culture positive. The sensitivity and specificity of Chest x-rays in sputum smear negative cases was 72% and 23% respectively. The positive predictive value was 32.5% and the negative predictive value