cross-sectional·pediatrics, infectious disease, epidemiology, public health, pulmonology·PMC10201244
Point-of-care ultrasound for tuberculosis diagnosis in children: a Médecins Sans Frontières cross-sectional study in Guinea-Bissau
BMJ Open · 20 authors, 13 centres
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In 139 children with presumptive TB at a hospital in Guinea-Bissau, point-of-care ultrasound (POCUS) showed 85% sensitivity for confirmed TB and 66% specificity in unlikely TB, with POCUS-positivity significantly associated with severe acute malnutrition but not HIV status or age.
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Two clinicians with 128 hours of POCUS training performed unblinded assessments of eight sonographic signs: lung consolidation, subpleural nodules, pleural effusion, pericardial effusion, hepatic and splenic focal lesions, ascites, and abdominal lymphadenopathy. POCUS sensitivity for confirmed TB was 85% (95% CI 67.5% to 94.1%) and specificity in unlikely TB was 66% (95% CI 52.2% to 77.6%). Common POCUS signs in TB patients included lung consolidation (57%), subpleural nodules (55%), and pleural effusion (30%). Limitations include the single-site design, unblinded operators, reliance on field interpretation as final read, and expert reviewers limited to saved clips.
