Evaluation of a short training course of chest X-ray interpretation for the diagnosis of paediatric TB
B. F. Melingui,
E. Leroy-Terquem,
M. Palmer,
J-V. Taguebue,
A. P. Wachinou,
J. Gaudelus,
A. Salomao,
D. Bunnet,
T. C. Eap,
L. Borand,
C. Chabala,
C. Khosa,
R. Moh,
J. Mwanga-Amumpere,
M. T. Eang,
I. Manhiça,
A. Mustapha,
S. Beneteau,
L. Falzon,
J. A. Seddon,
L. Berteloot,
E. Wobudeya,
O. Marcy,
M. Bonnet,
P. Y. Norval
Affiliations
B. F. Melingui
Recherches Translationnelles sur le VIH et les Maladies Infectieuses, University of Montpellier, Institut de Recherche pour le Développement (IRD), Institut national de la santé et de la recherche médicale (INSERM) Unité 1175, Montpellier,
E. Leroy-Terquem
International Pulmonology Support, François Quesnay Hospital, Mantes-la-Jolie, France;
M. Palmer
Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa;
J-V. Taguebue
Mother and Child Center, Chantal Biya Foundation, Yaoundé, Cameroon;
A. P. Wachinou
National Teaching Hospital for Tuberculosis and Pulmonary Diseases, Akpakpa Abokicodji, Cotonou, Benin;
J. Gaudelus
Service de Pediatrie, Hôpital Jean Verdier, Hôpitaux Universitaires Paris Seine Saint Denis, Bondy, France;
A. Salomao
Independent Public Health Consultant, Maputo, Mozambique;
D. Bunnet
Epidemiology and Public Health Unit, Pasteur Institute in Cambodia, Phnom Penh,
T. C. Eap
National TB Programme, Phnom Penh,
L. Borand
Epidemiology and Public Health Unit, Clinical Research Group, Institut Pasteur du Cambodge, Phnom Penh, Cambodia;
C. Chabala
Children’s Hospital, University Teaching Hospital, Lusaka, Zambia;
C. Khosa
Instituto Nacional de Saúde, Marracuene, Mozambique;
R. Moh
Programme ANRS Coopération Côte d'Ivoire, Centre hospitalière universitaire de Treichville, Abidjan, Côte d’Ivoire;
J. Mwanga-Amumpere
Epicentre Mbarara Research Centre, Mbarara, Uganda;
M. T. Eang
National Center for Tuberculosis and Leprosy (CENAT/NTP), Ministry of Health, Phnom Penh, Cambodia;
I. Manhiça
Programa Nacional de Controlo da Tuberculose, Ministério da Saúde, Maputo, Mozambique;
A. Mustapha
Ola During Children Hospital, Freetown, Sierra Leone;
S. Beneteau
Recherches Translationnelles sur le VIH et les Maladies Infectieuses, University of Montpellier, Institut de Recherche pour le Développement (IRD), Institut national de la santé et de la recherche médicale (INSERM) Unité 1175, Montpellier,
L. Falzon
International Pulmonology Support, Paris, France;
J. A. Seddon
Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa;
L. Berteloot
Department of Pediatric Radiology, University Hospital Necker-Enfants Malades, Assistance Publique – Hôpitaux de Paris, Paris, France;
E. Wobudeya
Makerere University-Johns Hopkins University Research Collaboration Care Ltd, Kampala, Uganda;
O. Marcy
University of Bordeaux, INSERM Unité mixte de Recherche 1219, IRD Unité Mixte de Recherche 271, Bordeaux,
M. Bonnet
Recherches Translationnelles sur le VIH et les Maladies Infectieuses, University of Montpellier, Institut de Recherche pour le Développement (IRD), Institut national de la santé et de la recherche médicale (INSERM) Unité 1175, Montpellier,
P. Y. Norval
Technical Assistance for Management, Paris, France
BACKGROUND: Chest X-ray (CXR) interpretation is challenging for the diagnosis of paediatric TB. We assessed the performance of a three half-day CXR training module for healthcare workers (HCWs) at low healthcare levels in six high TB incidence countries. METHODS: Within the TB-Speed Decentralization Study, we developed a three half-day training course to identify normal CXR, CXR of good quality and identify six TB-suggestive features. We performed a pre–post training assessment on a pre-defined set of 20 CXR readings. We compared the proportion of correctly interpreted CXRs and the median reading score before and after the training using the McNemar test and a linear mixed model. RESULTS: Of 191 HCWs, 43 (23%) were physicians, 103 (54%) nurses, 18 (9.4%) radiology technicians and 12 (6.3%) other professionals. Of 2,840 CXRs with both assessment, respectively 1,843 (64.9%) and 2,277 (80.2%) were correctly interpreted during pre-training and post-training (P < 0.001). The median reading score improved significantly from 13/20 to 16/20 after the training, after adjusting by country, facility and profession (adjusted β = 3.31, 95% CI 2.44–4.47). CONCLUSION: Despite some limitations of the course assessment that did not include abnormal non-TB suggestive CXR, study findings suggest that a short CXR training course could improve HCWs’ interpretation skills in diagnosing paediatric TB.
