Browsing by Author "Singini DS"

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    Clinical diagnosis of TB: lessons on misdiagnosis and overdiagnosis.
    (2025-Jun) Singini DS; Sanjase N; Kagujje M; Shatalimi J; Chisanga CP; Lupatali ZD; Phiri D; Tatila T; Olwit W; Kerkhoff AD; Muyoyeta M; University of California, Division of HIV, Infectious Diseases, and Global Medicine, Department of Medicine, Zuckerberg San Francisco General Hospital, San Francisco, USA.; Uganda Cancer Institute, Kampala, Uganda.; Centre for Infectious Disease Research in Zambia, Lusaka, Zambia.; The Ministry of Health, Lusaka, Zambia.; CIDRZ; Centre for Infectious Disease Research in Zambia (CIDRZ)
    Clinically diagnosed TB patients (n = 335) at two facilities in Lusaka, Zambia were re-evaluated within two weeks of diagnosis. This re-evaluation included sputum Xpert Ultra testing and expert reader interpretation of the chest x-rays (CXRs) used for initial diagnosis. Repeat Xpert Ultra detected TB in just 2.6% (n=6). Of the remaining patients (n=222), expert CXR re-interpretation classified 18.0% as normal; 36.0% as abnormal, consistent with TB; and 46.0% as abnormal, not consistent with TB. These findings suggest that clinical TB is frequently over diagnosed in those without detectable CXR abnormalities and misdiagnosed in those with abnormal CXRs: these abnormalities are likely due to other respiratory conditions. Such misdiagnosis leads to unnecessary treatment, failure to treat the true underlying condition and incorrect estimates of TB burden.