Bulletin of the World Health Organization

Global burden of chronic pulmonary aspergillosis as a sequel to pulmonary tuberculosis

David W Denning, Alex Pleuvry & Donald C Cole

Volume 89, Number 12, December 2011, 864-872

Table 1. Summary of published studies evaluating cavitation on chest radiograph or computerized tomography (CT) scan after anti-tuberculous treatment

Reference Design Population Relevant measure(s) Frequencies
Sonnenberg (2000)20 Prognostic cohort for TB outcomes (exclusion of MDR cases and those not cured of TB), stratified by HIV status Gold miners in South Africa Chest X-ray at 3 & 6 months after cure Residual cavitation at cure - 69/326 (21%)
[HIV strong first factor for TB recurrence among those without cavitation]
Bombarda (2003)21 Repeat measures (unclear if losses to follow-up) during active disease and then after treatment conclusion Referral hospital PTB patients Repeated conventional CT scans Thick-walled cavities post treatment 1/20 (5%) and thin-walled cavities post treatment 5/20 (25%); together, 30%
? selected population
De Vallière (2004)19 Post-treatment cross-sectional survey (reporting on 33/42 patients who completed treatment – no comment on selection) Patients registered in MDR-TB programme in Limpopo province, South Africa Chest X-ray based on two observers % with cavities – observer 2, 17/33 (52%) to observer 1, 23/33 (70%)
Hamilton (2008)17 Prognostic cohort of post-treatment (6 months), 170 exclusions from 1 004 subjects primarily for missing test results Multi-centre North American TB trials Consortium RCT Chest X-ray, consensus criteria, reading kappa 0.54 for cavity (80% raw agreement) EOT cavity, 23.3% (n = 834) in EOT chest X-ray analysis vs 19.1% among those excluded from main analysis (n = 170)
Lee (2008)18 Pre- and post-treatment repeat scans (excluded 31/83, primarily loss to follow-up, 23) Taiwan, China, general hospital n = 52 High resolution chest CT scan Post-treatment, 18/52 (35%) vs pre-treatment, 38/52 (73%)

EOT, end-of-treatment; HIV, human immunodeficiency virus; MDR, multi-drug resistant; PTB, pulmonary tuberculosis; RCT, randomized controlled trial; TB, tuberculosis.