Chest X-rays inadequate to detect asymptomatic TB among household contacts: The Lancet

Commonly used chest Xrays based on symptoms are inadequate to detect asymptomatic tuberculosis TB infection among household contacts according to a study published in the journal The Lancet Global HealthResearchers from the University of Cape Town South Africa conducted systematic screening with universal sputum microbiological testing of 979 household contacts of people with pulmonary tuberculosis in three South African communitiesThey compared tuberculosis symptom any duration and chest radiograph any abnormality indicative of active tuberculosis screening approaches against a microbiological reference standardThe team confirmed pulmonary tuberculosis in 5middot2 per cent of household contacts and 82middot4 per cent of these reported no symptoms Alarmingly the chest radiographs were not able to detect 40 per cent of the casesldquoMore than 80 per cent of confirmed people with tuberculosis among household contacts were asymptomatic chest radiograph screening missed more than 40 per cent of theserdquo said corresponding author Dr Simon C Mendelsohn South African Tuberculosis Vaccine Initiative at the varsityldquoCommunity prevalence surveys reliant on symptombased and chest radiographbased approaches might substantially underestimate the prevalence of asymptomatic tuberculosis in endemic countriesrdquo he addedAccording to the World Health Organization WHO approximately 2middot7 million 25 per cent of the estimated 10middot8 million people with tuberculosis worldwide went undiagnosed or untreated in 2023While finding and treating these socalled missing millions is crucial the challenge is that a majority of these remain asymptomaticldquoMore than half of all tuberculosis found in community prevalence surveys has been classified as asymptomatic occurring in people who do not have recognise or report typical tuberculosis symptoms such as cough fever night sweats and loss of weightrdquo the team said in the paperIn the study asymptomatic tuberculosis in household contacts had low bacterial load and were also associated with low serum Creactive protein concentrations that were indistinguishable from those of healthy controls However these were distinct from symptomatic tuberculosis in a comparator group of clinic attendeesSensitivity of chest radiograph screening for asymptomatic tuberculosis was only 56middot1 per cent sensitivity of combined symptom and chest radiograph screening for all tuberculosis was marginally higher at 64middot0 per centldquoOur findings from household contacts suggest that symptombased and chest radiographbased approaches are inadequate for community tuberculosis screening and do not meet the WHO target product profile for a tuberculosis screening test minimum 90 per cent sensitivity 70 per cent specificity National tuberculosis prevalence surveys that omit universal sputum microbiological testing might substantially underestimate the prevalence of asymptomatic tuberculosis in highburden countriesrdquo Mendelsohn saidThis story has been sourced from a third party syndicated feed agencies Midday accepts no responsibility or liability for its dependability trustworthiness reliability and data of the text Midday managementmiddaycom reserves the sole right to alter delete or remove without notice the content in its absolute discretion for any reason whatsoever