ETD Collection

Permanent URI for this collectionhttps://wiredspace.wits.ac.za/handle/10539/104


Please note: Digitised content is made available at the best possible quality range, taking into consideration file size and the condition of the original item. These restrictions may sometimes affect the quality of the final published item. For queries regarding content of ETD collection please contact IR specialists by email : IR specialists or Tel : 011 717 4652 / 1954

Follow the link below for important information about Electronic Theses and Dissertations (ETD)

Library Guide about ETD

Browse

Filters

20181

Settings

Author: search.filters.author.Baker, GregoryHas files: Yes

Search Results

Now showing 1 - 1 of 1
  • No Thumbnail Available
    Item
    Comparison of Chest X-ray findings in ambulatory and hospitalised children with pulmonary TB
    (2018) Baker, Gregory
    INTRODUCTION: Pulmonary TB is common in South Africa, with many children affected. Diagnosis can be challenging and chest x-ray remains fundamental for diagnosis. Interpretation is difficult and shown to have wide inter-reader variability. No study however has compared CXR findings and inter-reader agreement between ambulatory and hospitalised patients. AIM: This study compares the frequency of CXR changes, as well as inter-reader agreement in ambulatory compared to hospitalised children with suspected TB. METHOD: A pre-existing database containing CXR data of children worked up for PTB from 2008-2013 was used. Retrospective analysis of 69 ambulatory and 112 hospitalised patients, aged 0-12 years from Nolungile clinic and Red Cross Children’s Hospital respectively was done. Each sample contained 50% proven TB and 50% negative controls. Two paediatric radiologists and one paediatrician served as blinded, independent readers for the database using standardised tick sheets. RESULTS: Finding frequency; Fleiss/Free marginal Kappa (ambulatory and hospitalised respectively): Overall TB: 27.5% and 35.7%; -0.07 and 0.12 /-0.06 and 0.12 Parenchymal change: 34.8% and 67.9%; 0.24 and 0.49/0.25 and 0.60 Lymphadenopathy: 24.6% and 33.9%; 0.01 and 0.13/0.01 and 0.13 Pleural effusion: 7.3% and 18.8%; 0.27 and 0.61/0.84 and 0.80 Airway compression: 11.6 and 17.9%; 0.26 and 0.20/0.73 and 0.52 CONCLUSIONS: Our study demonstrated no significant difference in lymphadenopathy, but an increase in parenchymal change in the hospitalised group. We otherwise showed comparable results to literature regarding finding frequency, but poor inter-observer agreement. If the least expert reader were removed, results were comparable with available literature. This highlights the need for development and study of explicit CXR criteria for lymphadenopathy to improve the value of CXR for paediatric TB in all settings.