The burden of subclinical TB in Nigeria.

IF 1.6 Q4 RESPIRATORY SYSTEM Public Health Action Pub Date : 2024-12-01 DOI:10.5588/pha.24.0038

B Odume, C Ogbudebe, Y Mukadi, C Dim, E Chukwu, O Chukwuogo, S Useni, N Nwokoye, M Sheshi, D Nongo, R Eneogu, A Ihesie, E Ubochioma, C Anyaike

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Abstract

Setting: This study is a retrospective review of a large-scale systematic TB screening project conducted in six states of Nigeria.

Objective: To determine the magnitude and characteristics of subclinical TB and the relative contributions of bacteriological versus clinical diagnosis in its identification in Nigeria.

Design: Data were retrospectively analysed from six states of Nigeria, where parallel screening with any TB symptoms and chest X-ray (CXR) with artificial intelligence (AI) was used for active case finding. Diagnosis of TB among presumptive was confirmed using either bacteriological tests or clinical review of CXR.

Results: Out of 8,516 presumptive identified during the project, 172 (2.0%) had no TB symptoms (males: 73.8%, females: 26.2%). The overall prevalence of TB among all presumptive was 21.9% (n = 1,867), including 62 (3.3%) subclinical TB and 1,805 (97.3%) active TB cases. The proportion of clinical diagnosis using CXR was significantly higher in the subclinical TB group than in the active TB group (79.0% vs. 63.5%; P = 0.012, OR = 2.2, 95% CI 1.17-4.03).

Conclusion: Subclinical TB contributed 3.3% of the large TB burden in this study (22 per 100 presumptive). These cases would have been missed if only symptom-based TB screening had been employed.

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尼日利亚亚临床结核病的负担。

背景：本研究是对在尼日利亚六个州开展的大规模系统性结核病筛查项目的回顾性审查。目的：确定尼日利亚亚临床结核的规模和特征，以及细菌学和临床诊断在其鉴定中的相对贡献。设计：回顾性分析尼日利亚六个州的数据，在这些州使用人工智能（AI）对任何结核病症状进行平行筛查和胸部x线检查（CXR）进行主动病例发现。结核的推定诊断是通过细菌学检查或临床审查的CXR证实。结果：在项目期间确定的8,516例推定中，172例（2.0%）没有结核症状（男性：73.8%，女性：26.2%）。所有推定的结核总患病率为21.9% (n = 1867)，包括62例（3.3%）亚临床结核和1805例（97.3%）活动性结核病例。临床诊断中使用CXR的比例在亚临床结核组显著高于活动性结核组(79.0% vs. 63.5%；P = 0.012, or = 2.2, 95% ci 1.17-4.03)。结论：在本研究中，亚临床结核病占结核病大负担的3.3%（每100例推定病例中有22例）。如果采用基于症状的结核病筛查，这些病例就会被遗漏。

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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Public Health Action RESPIRATORY SYSTEM-

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期刊介绍： Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.