Active case finding to detect symptomatic and subclinical pulmonary tuberculosis disease: implementation of computer-aided detection for chest radiography in Viet Nam.

IF 1 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Western Pacific Surveillance and Response Pub Date : 2024-10-12 eCollection Date: 2024-10-01 DOI:10.5365/wpsar.2024.15.4.1118
Anh L Innes, Andres Martinez, Gia Linh Hoang, Thi Bich Phuong Nguyen, Viet Hien Vu, Tuan Ho Thanh Luu, Thi Thu Trang Le, Victoria Lebrun, Van Chinh Trieu, Nghi Do Bao Tran, Nhi Dinh, Huy Minh Pham, Van Luong Dinh, Binh Hoa Nguyen, Thi Thanh Huyen Truong, Van Cu Nguyen, Viet Nhung Nguyen, Thu Hien Mai
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引用次数: 0

Abstract

Objective: In Viet Nam, tuberculosis (TB) prevalence surveys revealed that approximately 98% of individuals with pulmonary TB have TB-presumptive abnormalities on chest radiographs, while 32% have no TB symptoms. This prompted the adoption of the "Double X" strategy, which combines chest radiographs and computer-aided detection with GeneXpert testing to screen for and diagnose TB among vulnerable populations. The aim of this study was to describe demographic, clinical and radiographic characteristics of symptomatic and asymptomatic Double X participants and to assess multilabel radiographic abnormalities on chest radiographs, interpreted by computer-aided detection software, as a possible tool for detecting TB-presumptive abnormalities, particularly for subclinical TB.

Methods: Double X participants with TB-presumptive chest radiographs and/or TB symptoms and known risks were referred for confirmatory GeneXpert testing. The demographic and clinical characteristics of all Double X participants and the subset with confirmed TB were summarized. Univariate and multivariable logistic regression modelling was used to evaluate associations between participant characteristics and subclinical TB and between computer-aided detection multilabel radiographic abnormalities and TB.

Results: From 2020 to 2022, 96 631 participants received chest radiographs, with 67 881 (70.2%) reporting no TB symptoms. Among 1144 individuals with Xpert-confirmed TB, 51.0% were subclinical. Subclinical TB prevalence was higher in older age groups, non-smokers, those previously treated for TB and the northern region. Among 11 computer-aided detection multilabel radiographic abnormalities, fibrosis was associated with higher odds of subclinical TB.

Discussion: In Viet Nam, Double X community case finding detected pulmonary TB, including subclinical TB. Computer-aided detection software may have the potential to identify subclinical TB on chest radiographs by classifying multilabel radiographic abnormalities, but further research is needed.

积极寻找病例以检测有症状和亚临床肺结核疾病:在越南实施胸部放射摄影计算机辅助检测。
目的:在越南,结核病(TB)患病率调查显示,约 98% 的肺结核患者在胸片上有结核病推测异常,而 32% 的患者没有结核病症状。这促使我们采用了 "双 X "策略,即结合胸片、计算机辅助检测和基因 Xpert 检测,对易感人群进行结核病筛查和诊断。本研究的目的是描述有症状和无症状的 Double X 参与者的人口统计学、临床和放射学特征,并评估由计算机辅助检测软件解读的胸片上的多标签放射学异常,以此作为检测结核病预后异常,尤其是亚临床结核病的可能工具:有肺结核推测胸片和/或肺结核症状及已知风险的 Double X 参与者被转介进行 GeneXpert 确证测试。总结了所有 Double X 参与者和确诊肺结核患者的人口统计学和临床特征。采用单变量和多变量逻辑回归模型评估参与者特征与亚临床肺结核之间的关系,以及计算机辅助检测多标签放射学异常与肺结核之间的关系:从 2020 年到 2022 年,96 631 名参与者接受了胸片检查,其中 67 881 人(70.2%)报告无结核病症状。在 1144 名经 Xpert 确诊的肺结核患者中,51.0% 为亚临床肺结核。亚临床肺结核发病率在年龄较大、不吸烟、曾接受过肺结核治疗的人群和北部地区较高。在 11 种计算机辅助检测多标签放射学异常中,纤维化与亚临床肺结核的几率较高有关:讨论:在越南,双 X 社区病例调查发现了肺结核,包括亚临床肺结核。计算机辅助检测软件有可能通过对多标签影像异常进行分类来识别胸片上的亚临床肺结核,但仍需进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Western Pacific Surveillance and Response
Western Pacific Surveillance and Response PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
1.70
自引率
0.00%
发文量
23
审稿时长
15 weeks
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