Is routine pre-entry chest radiograph necessary in a high tuberculosis prevalence country?


Journal

Journal of postgraduate medicine
ISSN: 0972-2823
Titre abrégé: J Postgrad Med
Pays: India
ID NLM: 2985196R

Informations de publication

Date de publication:
Historique:
entrez: 10 4 2020
pubmed: 10 4 2020
medline: 18 11 2020
Statut: ppublish

Résumé

Chest radiographs have been used worldwide as a screening tool before employment and training, by various healthcare and other government and nongovernment institutions. Many studies done in the past have demonstrated a relatively low yield for tuberculosis detection and therefore, the authors have questioned this practice. To compare the value of the preadmission/employment chest radiograph in two groups, namely, those who have been previously exposed to a healthcare setting (post-exposure group) and those who have not been exposed (pre-exposure group) and to determine if there is a significant difference in tuberculosis detection between these two groups. A retrospective review of the reports of the chest radiographs of all candidates appearing for admission to various undergraduate and postgraduate courses in our institute between 2014 and 2017 was performed. The various abnormalities detected were recorded and the findings in the two groups were compared. Chi-square test was used to compare between two group proportions. Thirty out of 4333 (0.69%) candidates in the pre-exposure group and 53 out of 3379 (1.57%) candidates in the post-exposure group showed abnormalities on chest radiographs involving the lung parenchyma, mediastinum, heart, or pleura. In the pre-exposure group, six (0.14%) were found to have underlying cardiac disease and one (0.02%) had tuberculosis. Among the six candidates in the post-exposure group who underwent further investigations in our institute, five (0.15%) were diagnosed to have tuberculosis. Although there was no statistically significant difference in tuberculosis detection between the groups (P = 0.051), there is a trend towards higher detection of tuberculosis in the post-exposure group. In a country where the prevalence of tuberculosis is high, the pre-employment chest radiograph may still have a role in detecting tuberculosis in the post-exposure group.

Identifiants

pubmed: 32270779
pii: jpgm_2020_66_2_90_281673
doi: 10.4103/jpgm.JPGM_462_19
pmc: PMC7239409
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

90-93

Déclaration de conflit d'intérêts

None

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Auteurs

A Jasper (A)

Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India.

S Gibikote (S)

Department of Radiology, Christian Medical College, Vellore, Tamil Nadu, India.

H Kirupakaran (H)

Department of Staff-Student Health Services, Christian Medical College, Vellore, Tamil Nadu, India.

D J Christopher (DJ)

Department of Pulmonary Medicine, Christian Medical College, Vellore, Tamil Nadu, India.

P Mathews (P)

Department of Geriatric Medicine, Christian Medical College, Vellore, Tamil Nadu, India.

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