{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T05:25:07Z","timestamp":1784093107890,"version":"3.55.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T00:00:00Z","timestamp":1641513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"publisher","award":["TMA2019SFP-2836"],"award-info":[{"award-number":["TMA2019SFP-2836"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute of Health Fogarty International Centre","award":["K43TW011028"],"award-info":[{"award-number":["K43TW011028"]}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/R007942\/1"],"award-info":[{"award-number":["MR\/R007942\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"US National Institutes of Health","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["F30HD105440"],"award-info":[{"award-number":["F30HD105440"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Yale Medical Scientist Training","award":["T32GM007205"],"award-info":[{"award-number":["T32GM007205"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The chest radiograph (CR) remains a key tool in the diagnosis of pediatric tuberculosis (TB). In children with presumptive intrathoracic TB, we aimed to identify CR features that had high specificity for, and were strongly associated with, bacteriologically confirmed TB.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We analyzed CR data from children with presumptive intrathoracic TB prospectively enrolled in a cohort study in a high-TB burden setting and who were classified using standard clinical case definitions as \u201cconfirmed,\u201d \u201cunconfirmed,\u201d or \u201cunlikely\u201d TB. We report the CR features and inter-reader agreement between expert readers who interpreted the CRs. We calculated the sensitivity and specificity of the CR features with at least moderate inter-reader agreement and analyzed the relationship between these CR &amp;#x2028;features and the classification of TB in a multivariable regression model.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of features with at least moderate inter-reader agreement, enlargement of perihilar and\/or paratracheal lymph nodes, bronchial deviation\/compression, cavities, expansile pneumonia, and pleural effusion had a specificity of\u2005&amp;gt;\u200590% for confirmed TB, compared with unlikely TB. Enlargement of perihilar (adjusted odds ratio [aOR]: 6.6; 95% confidence interval [CI], 3.80\u201311.72) and\/or paratracheal lymph nodes (aOR: 5.14; 95% CI, 2.25\u201312.58), bronchial deviation\/compression (aOR: 6.22; 95% CI, 2.70\u201315.69), pleural effusion (aOR: 2.27; 95% CI, 1.04\u20134.78), and cavities (aOR: 7.45; 95% CI, 3.38\u201317.45) were associated with confirmed TB in the multivariate regression model, whereas alveolar opacification (aOR: 1.16; 95% CI, .76\u20131.77) and expansile pneumonia (aOR: 4.16; 95% CI, .93\u201322.34) were not.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In children investigated for intrathoracic TB enlargement of perihilar or paratracheal lymph nodes, bronchial compression\/deviation, pleural effusion, or cavities on CR strongly support the diagnosis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac011","type":"journal-article","created":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T20:14:31Z","timestamp":1641413671000},"page":"1014-1021","source":"Crossref","is-referenced-by-count":17,"title":["The Diagnostic Accuracy of Chest Radiographic Features for Pediatric Intrathoracic Tuberculosis"],"prefix":"10.1093","volume":"75","author":[{"given":"Megan","family":"Palmer","sequence":"first","affiliation":[{"name":"Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth S","family":"Gunasekera","sequence":"additional","affiliation":[{"name":"Department of Epidemiology of Microbial Diseases, Yale School of Public Health , New Haven, Connecticut , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke M","family":"van der Zalm","sequence":"additional","affiliation":[{"name":"Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Morrison","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Simon Schaaf","sequence":"additional","affiliation":[{"name":"Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town , South Africa"},{"name":"Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Goussard","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anneke C","family":"Hesseling","sequence":"additional","affiliation":[{"name":"Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town , South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Walters","sequence":"additional","affiliation":[{"name":"Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town , South Africa"},{"name":"Great North Children\u2019s Hospital, Newcastle upon Tyne Hospitals Trust , Newcastle , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A","family":"Seddon","sequence":"additional","affiliation":[{"name":"Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town , South Africa"},{"name":"Department of Infectious Diseases, Imperial College London , London , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,1,7]]},"reference":[{"key":"2022092921003928300_CIT0001","article-title":"Global tuberculosis report. 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