Ultrasound in managing extrapulmonary tuberculosis: a randomized controlled two-center study

Ndege, Robert; Ngome, Omary; Bani, Farida; Temba, Yvan; Wilson, Herieth; Vanobberghen, Fiona; Hella, Jerry; Gingo, Winfrid; Sasamalo, Mohamed; Mnzava, Dorcas; Kimera, Namvua; Hiza, Helen; Wigayi, John; Mapesi, Herry; Kato, Irene B.; Mhimbira, Francis; Reither, Klaus; Battegay, Manuel; Paris, Daniel; Weisser, Maja; Rohacek, Martin

doi:10.1186/s12879-020-05073-9

Cited by 8 publications

(11 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For ePTB, a two-center RCT is underway in Tanzania to evaluate whether ultrasound in combination with other tests can increase the proportion of correctly treated patients. (Ndege et al 2020) Poor standardization of skills POCUS is now rapidly being adopted by non-radiologist clinicians. Many studies therefore compare the skills of the clinician with that of the radiologist and often show encouraging outcomes (Strøm et al 2020).…”

Section: Lack Of Trials Showing An Impactmentioning

confidence: 99%

Point-of-care ultrasound for tuberculosis management in Sub-Saharan Africa—a balanced SWOT analysis

Suttels

Toit

Fiogbé³

et al. 2022

International Journal of Infectious Diseases

View full text Add to dashboard Cite

Section: Lack Of Trials Showing An Impactmentioning

confidence: 99%

Point-of-care ultrasound for tuberculosis management in Sub-Saharan Africa—a balanced SWOT analysis

Suttels

Toit

Fiogbé³

et al. 2022

International Journal of Infectious Diseases

View full text Add to dashboard Cite

“…Many important research questions have already been answered through use of the prospective database of the KIULARCO Cohort [ 2 , 5 ] and it continues to provide a rich resource to address newly arising questions. Additionally, CDCI serves increasingly as a platform for clinical trials nested within the collaborative activities, such as a randomized controlled two center trial to study the added value of sonography in the management of patients with suspected extrapulmonary tuberculosis [ 22 ], the CoArtHA trial to identify the best antihypertensive drug strategy [ 23 ] or the GIVE-MOVE trial to analyze the impact of drug resistance testing in children and adolescents failing on first line treatment on the treatment outcome [ 24 ].…”

Section: Researchmentioning

confidence: 99%

The Chronic Diseases Clinic of Ifakara (CDCI)—Establishing a Model Clinic for Chronic Care Delivery in Rural Sub-Saharan Africa

Weisser

Rohacek²,

Ndege³

et al. 2022

Diseases

View full text Add to dashboard Cite

The rollout of antiretroviral drugs in sub-Saharan Africa to address the huge health impact of the HIV pandemic has been one of the largest projects undertaken in medical history and is an unprecedented medical success story. However, the path has been and still is characterized by many far reaching implementational challenges. Here, we report on the building and maintaining of a role model clinic in Ifakara, rural Southwestern Tanzania, within a collaborative project to support HIV services within the national program, training for staff and integrated research to better understand local needs and improve patients’ outcomes.

show abstract

“…The GeneXpert MTB/RIF assay, a heminested real-time polymerase chain reaction method, has high diagnostic power for pulmonary samples but low sensitivity for extrapulmonary samples ( 16 , 17 ). Imaging methods, such as ultrasound and computed tomography, can only assist in paracentesis and tissue biopsy but cannot provide a definitive diagnosis ( 18 , 19 ). Therefore, developing a detection method which is rapid, efficient, and economical would be conducive to both the early detection, and timely and effective treatment of abdominal TB.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic performance of adenosine deaminase for abdominal tuberculosis: A systematic review and meta-analysis

Zhou

Qiu

Ying

et al. 2022

Front. Public Health

View full text Add to dashboard Cite

Background and aimAbdominal tuberculosis (TB) is a common type of extrapulmonary TB with an insidious onset and non-specific symptoms. Adenosine deaminase (ADA) levels increase rapidly in the early stages of abdominal TB. However, it remains unclear whether ADA serves as a diagnostic marker for abdominal TB.MethodsWe performed a systematic literature search for relevant articles published in PubMed, Web of Science, Cochrane Library, and Embase up to April 2022. First, we used the Quality Assessment of Diagnostic Accuracy Studies tool-2 (QUADAS-2), to evaluate the quality of the included articles. Bivariate and hierarchical summary receiver operating characteristic (HSROC) models were then utilized to analyze pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under the receiver operating characteristic curve (AUROC). In addition, we explored a subgroup analysis for potential heterogeneity and publication bias among the included literature.ResultsTwenty-four articles (3,044 participants, 3,044 samples) which met the eligibility criteria were included in this study. The pooled sensitivity and specificity of ADA for abdominal TB detection were 93% [95% confidence interval (CI): 0.89–0.95] and 95% (95% CI: 0.93–0.96), respectively. PLR and NLR were 18.6 (95% CI: 14.0–24.6) and 0.08 (95% CI: 0.05–0.12), respectively. DOR and AUROC were 236 (95% CI: 134–415) and 0.98 (95% CI: 0.96–0.99), respectively. Furthermore, no heterogeneity or publication bias was found.ConclusionsOur meta-analysis found ADA to be of excellent diagnostic value for abdominal TB and could be used as an auxiliary diagnostic tool.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42022297931.

show abstract

Ultrasound in managing extrapulmonary tuberculosis: a randomized controlled two-center study

Abstract: Background: Patients with clinically suspected tuberculosis are often treated empirically, as diagnosis -especially of extrapulmonary tuberculosis -remains challenging. This leads to an overtreatment of tuberculosis and to underdiagnosis of possible differential diagnoses.

Cited by 8 publications

References 28 publications

Point-of-care ultrasound for tuberculosis management in Sub-Saharan Africa—a balanced SWOT analysis

Point-of-care ultrasound for tuberculosis management in Sub-Saharan Africa—a balanced SWOT analysis

The Chronic Diseases Clinic of Ifakara (CDCI)—Establishing a Model Clinic for Chronic Care Delivery in Rural Sub-Saharan Africa

Diagnostic performance of adenosine deaminase for abdominal tuberculosis: A systematic review and meta-analysis

Contact Info

Product

Resources

About