{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T06:37:08Z","timestamp":1787899028360,"version":"build-2784847793"},"reference-count":42,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The prevalence of diseases other than tuberculosis (TB) detected during chest X\u2010ray screening is poorly described in sub\u2010Saharan Africa. Computer\u2010assisted digital chest X\u2010ray technology is available for TB screening and has the potential to be a screening tool for non\u2010communicable diseases as well. Low\u2010 and middle\u2010income countries are in a transition period where the burden of non\u2010communicable diseases is increasing, but health systems are mainly focused on addressing infectious diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants were adults undergoing computer\u2010assisted chest X\u2010ray screening for tuberculosis in a community\u2010wide tuberculosis prevalence survey in Blantyre, Malawi. Adults with abnormal radiographs by field radiographer interpretation were evaluated by a physician in a community\u2010based clinic. X\u2010ray classifications were compared to classifications of a random sample of normal chest X\u2010rays by radiographer interpretation. Radiographic features were classified using WHO Integrated Management for Adult Illnesses (IMAI) guidelines. All radiographs taken at the screening tent were analysed by the Qure.ai qXR v2.0\u00a0software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>5% (648\/13,490) of adults who underwent chest radiography were identified to have an abnormal chest X\u2010ray by the radiographer. 387 (59.7%) of the participants attended the X\u2010ray clinic, and another 387 randomly sampled normal X\u2010rays were available for comparison. Participants who were referred to the community clinic had a significantly higher HIV prevalence than those who had been identified to have a normal CXR by the field radiographer (90 [23.3%] vs. 43 [11.1%] <jats:italic>p<\/jats:italic>\u2010value &lt; 0.001). The commonest radiographic finding was cardiomegaly (20.7%, 95% CI 18.0\u201323.7). One in five (81\/387) chest X\u2010rays were misclassified by the radiographer. The overall mean Qure.ai qXR v2.0\u00a0score for all reviewed X\u2010rays was 0.23 (SD 0.20). There was a high concordance of cardiomegaly classification between the physician and the computer\u2010assisted software (109\/118, 92.4%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is a high burden of cardiomegaly on a chest X\u2010ray at a community level, much of which is in patients with diabetes, heart disease and high blood pressure. Cardiomegaly on chest X\u2010ray may be a potential tool for screening for cardiovascular NCDs at the primary care level as well as in the community.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.13658","type":"journal-article","created":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T13:39:41Z","timestamp":1627047581000},"page":"1427-1437","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Pattern of abnormalities amongst chest X\u2010rays of adults undergoing computer\u2010assisted digital chest X\u2010ray screening for tuberculosis in Peri\u2010Urban Blantyre, Malawi: A cross\u2010sectional study"],"prefix":"10.1111","volume":"26","author":[{"given":"Hussein H.","family":"Twabi","sequence":"first","affiliation":[{"name":"Malawi\u2013Liverpool\u2013Wellcome Trust Clinical Research Programme Blantyre Malawi"},{"name":"College of Medicine Helse Nord TB Initiative University of Malawi Blantyre Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robina","family":"Semphere","sequence":"additional","affiliation":[{"name":"College of Medicine Helse Nord TB Initiative University of Malawi Blantyre Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madalo","family":"Mukoka","sequence":"additional","affiliation":[{"name":"College of Medicine Helse Nord TB Initiative University of Malawi Blantyre Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingstone","family":"Chiume","sequence":"additional","affiliation":[{"name":"Malawi\u2013Liverpool\u2013Wellcome Trust Clinical Research Programme Blantyre Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Nzawa","sequence":"additional","affiliation":[{"name":"Malawi\u2013Liverpool\u2013Wellcome Trust Clinical Research Programme Blantyre Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena R. 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