Thoracic ultrasound for TB diagnosis in adults and children

M Fentress¹, P C Henwood², P Maharaj³, M Mitha³, D Khan³, R Jackpersad⁴, R Pitcher⁵, A Redfern⁶, E Lopez Varela^{7

8}, M M van der Zalm⁸, E B Wong^{9

10}, M Palmer⁸, A D Grant^{1

11

12}

Affiliations

¹ TB Centre, London School of Hygiene & Tropical Medicine, London, UK.
² Thomas Jefferson University, Philadelphia, PA, USA.
³ Department of Pulmonology and Critical Care, Inkosi Albert Luthuli Central Hospital, Durban, South Africa.
⁴ Advanced Imaging and Therapy, Durban, South Africa.
⁵ Division of Radiodiagnosis, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
⁶ Department of Paediatrics & Child Health, Tygerberg Hospital, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
⁷ ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universidad de Barcelona, Barcelona, Spain.
⁸ Desmond Tutu TB Centre, Department of Paediatrics & Child Health, Tygerberg Hospital, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
⁹ Africa Health Research Institute, KwaZulu-Natal, South Africa.
¹⁰ Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
¹¹ Africa Health Research Institute, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
¹² School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.

PMID: 35317533
PMCID: PMC8908869
DOI: 10.5588/pha.21.0072

Thoracic ultrasound for TB diagnosis in adults and children

M Fentress et al. Public Health Action. 2022.

. 2022 Mar 21;12(1):3-6.

doi: 10.5588/pha.21.0072.

Authors

Affiliations

¹ TB Centre, London School of Hygiene & Tropical Medicine, London, UK.
² Thomas Jefferson University, Philadelphia, PA, USA.
³ Department of Pulmonology and Critical Care, Inkosi Albert Luthuli Central Hospital, Durban, South Africa.
⁴ Advanced Imaging and Therapy, Durban, South Africa.
⁵ Division of Radiodiagnosis, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
⁶ Department of Paediatrics & Child Health, Tygerberg Hospital, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
⁷ ISGlobal, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universidad de Barcelona, Barcelona, Spain.
⁸ Desmond Tutu TB Centre, Department of Paediatrics & Child Health, Tygerberg Hospital, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
⁹ Africa Health Research Institute, KwaZulu-Natal, South Africa.
¹⁰ Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
¹¹ Africa Health Research Institute, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
¹² School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.

PMID: 35317533
PMCID: PMC8908869
DOI: 10.5588/pha.21.0072

Abstract
in English, French

Thoracic ultrasound is an appealing alternative to chest radiography for the diagnosis of TB. Based on research experience conducting thoracic ultrasound for adults and children in South Africa, three key considerations for potential scale-up were identified. First, thoracic ultrasound requires a comprehensive training programme for novice users; artificial intelligence may be used to simplify training and interpretation. Second, a robust ultrasound device is needed with good subpleural resolution and a probe suitable for children. Third, comprehensive scanning of the lungs is time-intensive, and shorter scanning protocols may be more feasible in clinical practice.

L’échographie thoracique est une alternative attrayante à la radiographie pulmonaire pour le diagnostic de la TB. En prenant appui sur l’expérience acquise lors d’études ayant utilisé l’échographie thoracique chez l’adulte et l’enfant en Afrique du Sud, trois considérations clés pour une éventuelle utilisation accrue de cet outil ont été identifiées. Premièrement, tout nouvel utilisateur d’un échographe thoracique doit suivre un programme de formation exhaustif. L’intelligence artificielle pourrait être utilisée pour simplifier la formation et l’interprétation des résultats. Deuxièmement, un échographe de qualité est nécessaire, avec une bonne résolution sous-pleurale et une sonde adaptée à l’enfant. Troisièmement, une scannographie exhaustive des poumons est chronophage ; des protocoles de scannographie plus courts pourraient être plus faciles en pratique clinique.

Keywords: thoracic ultrasound; tuberculosis; user experience.

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Figures

**FIGURE 1**
Comparison of standard and novel ultrasound devices in study participants. Large consolidation (arrowhead), characterised by subpleural echo poor or tissue-like region ⩾1 cm in depth or length, seen on standard device (Panel A) is adequately imaged on novel device (Panel B). More subtle, small subpleural consolidation (thin arrow), characterised by hypoechoic subpleural region less than 1 cm x 1 cm, with distinct borders and posterior trailing artifact, seen on standard device (Panel C) is sub-optimally imaged on novel device (Panel D).

**FIGURE 2**
Example of suprasternal notch imaging in paediatric patient.

See this image and copyright information in PMC

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Thoracic ultrasound for TB diagnosis in adults and children

Affiliations

Thoracic ultrasound for TB diagnosis in adults and children

Authors

Affiliations

Abstract
in English, French

Figures

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Abstract in English, French

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Abstract
in English, French