Chest radiography is not specific enough to act as the sole test for tuberculosis (TB), yet it is still overutilized by physicians assessing for the disease, according to the International Standards for Tuberculosis Care (ISTC) guidelines.
The report was published by the World Health Organization (WHO) and the American Thoracic Society, which joined with other international organizations to form the Tuberculosis Coalition for Technical Assistance (TBCTA).
The guidelines lay out standards for diagnosis, stating that "all persons with chest radiographic findings suggestive of tuberculosis should have sputum specimens submitted for microbiological examination" (ISTC, January 2006, p. 6).
The authors stated that a TB diagnosis cannot be established by radiography alone. They cited two WHO studies that indicated that TB would have been missed by x-ray but not by sputum cultures or photofluorography (Toman's tuberculosis: Case detection, treatment and monitoring, WHO, Geneva, 2004).
"Chest radiography ... is most useful when applied as a part of a systematic approach," the ISTC group wrote. "Underdiagnosis will lead to more severe consequences of (TB) including disability and possibly death as well as ongoing transmission."
By AuntMinnie.com staff writers
March 29, 2006
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Tuberculosis: Managing an old disease with modern medicine, August 12, 2004
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