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Volume 30, Number 6—June 2024
Research

Chest Radiograph Screening for Detecting Subclinical Tuberculosis in Asymptomatic Household Contacts, Peru

Qi Tan1, Chuan-Chin Huang1, Mercedes C. Becerra, Roger Calderon, Carmen Contreras, Leonid Lecca, Judith Jimenez, Rosa Yataco, Jerome T. Galea, Jia-Yih Feng, Sheng-Wei Pan, Yen-Han Tseng, Jhong-Ru Huang, Zibiao Zhang, and Megan B. MurrayComments to Author 
Author affiliations: Harvard Medical School, Boston, Massachusetts, USA (Q. Tan, C.-C. Huang, M.C. Becerra, M.B. Murray); Brigham and Women’s Hospital, Boston (C.-C. Huang, M.C. Becerra, Z. Zhang, M.B. Murray); Partners In Health—Socios En Salud Sucursal Peru, Lima, Peru (R. Calderon, C. Contreras, L. Lecca, J. Jimenez, R. Yataco); University of South Florida, Tampa, Florida, USA (J.T. Galea); Taipei Veterans General Hospital, Taipei, Taiwan (J.-Y. Feng, S.-W. Pan, Y.-H. Tseng, J.-R. Huang); National Yang Ming Chiao Tung University, Taipei (J.-Y. Feng, S.-W. Pan, Y.-H. Tseng, J.-R. Huang); Harvard T.H. Chan School of Public Health, Boston (M.B. Murray)

Main Article

Table 3

Chest radiograph and symptom screening results and association with risk for subsequent TB, by age group, Peru*

Age group, y†
 No. (%) incident TB cases
Univariate analysis
Multivariate analysis
Hazard ratio (95% CI)
 p value
 Hazard ratio (95% CI)
 p value
16–24 n = 370, events = 25 n = 360, events = 24‡
CXR–SX– 9 (0.3) Referent Referent
CXR–SX+ 4 (7) 2.25 (0.69–7.31) 0.18 2.12(0.59–7.55) 0.25
CXR+SX– 9 (50) 20.47 (8.11–51.64) <0.001 19.12 (7.19–50.79) <0.001
CXR+SX+
 3 (50)
 24.26 (6.53–90.12)
 <0.001
21.03 (5.12–86.30)
 <0.001
25–45 n = 709, events = 13 n = 664, events = 13§
CXR–SX– 6 (1) Referent Referent
CXR–SX+ 1 (1) 0.93 (0.11–7.73) 0.95 0.89 (0.11–7.57) 0.92
CXR+SX– 3 (8) 8.38 (2.09–33.51) <0.01 8.85 (2.09–37.44) <0.01
CXR+SX+
 3 (33)
 33.21 (8.29–132.97)
 <0.001
28.89 (6.07–137.67)
 <0.001
>45 n = 668, events = 14 n = 630, events = 14¶
CXR–SX– 3 (0.6) Referent Referent
CXR–SX+ 2 (2) 3.23 (0.53–19.32) 0.19 3.01 (0.49–18.44) 0.23
CXR+SX– 8 (14) 24.21 (6.42–91.26) <0.001 18.32 (4.37–76.87) <0.001
CXR+SX+ 1 (12) 22.98 (2.39–220.96) <0.01 29.22 (2.42–352.91) <0.001

*In both analyses, n indicates number of analyzed participants and event indicates number of participants in whom incident TB developed. CXR–, unremarkable chest radiograph, CXR+, abnormal chest radiograph; SX–, no symptoms; SX+, symptoms; TB, tuberculosis. †Symptoms were defined as any of the following: cough >14 d, cough with blood or phlegm, fever, shortness of breath, night sweats. Abnormal chest radiograph was defined as a radiograph with any intra-thorax abnormalities compatible with TB. Abnormal CXR was defined as a CXR with any intra-thorax abnormalities compatible with TB. ‡Adjusted for sex, cardiovascular disease, kidney disease, asthma, TB history, and body mass index. All persons in this age group were HIV negative. §Adjusted for sex, alcohol use, hypertension, kidney disease, asthma, TB history, and body mass index. HIV-positive persons (n = 4) were excluded. ¶Adjusted for sex, alcohol use, tobacco use, diabetes, hypertension, TB history, and body mass index. All persons in this age group were HIV negative.

Main Article

1These authors contributed equally to this article.

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