Odume B, Ogbudebe C, Mukadi Y, Dim C, Chukwu E, Chukwuogo O, Useni S, Nwokoye N, Sheshi M, Nongo D, Eneogu R, Ihesie A, Ubochioma E, Anyaike C
KNCV Tuberculosis Foundation, Abuja, Nigeria.
United States Agency for International Development (USAID), Washington, DC, USA.
Public Health Action. 2024 Dec 1;14(4):181-185. doi: 10.5588/pha.24.0038. eCollection 2024 Dec.
This study is a retrospective review of a large-scale systematic TB screening project conducted in six states of Nigeria.
To determine the magnitude and characteristics of subclinical TB and the relative contributions of bacteriological versus clinical diagnosis in its identification in Nigeria.
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.
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% ( = 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%; = 0.012, OR = 2.2, 95% CI 1.17-4.03).
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.
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分析。
确定尼日利亚亚临床结核病的规模和特征，以及细菌学诊断与临床诊断在亚临床结核病识别中的相对贡献。
对尼日利亚六个州的数据进行回顾性分析，在这些地区采用针对任何结核病症状的平行筛查以及利用人工智能（AI）的胸部X光（CXR）检查进行主动病例发现。对疑似病例通过细菌学检测或CXR的临床评估来确诊结核病。
在该项目期间确定的8516例疑似病例中，172例（2.0%）无结核病症状（男性：73.8%，女性：26.2%）。所有疑似病例中结核病的总体患病率为21.9%（n = 1867），包括62例（3.3%）亚临床结核病和1805例（97.3%）活动性结核病病例。亚临床结核病组中使用CXR进行临床诊断的比例显著高于活动性结核病组（79.0%对63.5%；P = 0.012，OR = 2.2，95%CI 1.17 - 4.03）。
在本研究中，亚临床结核病占结核病总负担的3.3%（每100例疑似病例中有22例）。如果仅采用基于症状的结核病筛查，这些病例将会被漏诊。
