Feasibility of using teleradiology to improve tuberculosis screening and case management in a district hospital in Malawi
Rebecca Marie Coulborn, Isabella Panunzi, Saskia Spijker, William E Brant, Laura Triviño Duran, Cara S Kosack & Michael Mitchell Murowa
Volume 90, Number 9, September 2012, 705-711
Table 1. Characteristics of patients studied and teleradiology images, Thyolo District Hospital, Malawi, 2010–2011
| Variable of interest | No. | % | 95% CI |
|---|---|---|---|
| Age (years) | |||
| < 15 | 22 | 13.9 | – |
| 15–24 | 15 | 9.5 | – |
| 25–34 | 40 | 25.3 | – |
| 35–44 | 30 | 19.0 | – |
| 45–54 | 31 | 19.6 | – |
| 55+ | 20 | 12.7 | – |
| Total | 158 | 100.0 | – |
| Sex | |||
| Male | 77 | 48.7 | – |
| Female | 80 | 50.6 | – |
| Unknown | 1 | 0.6 | – |
| Total | 158 | 100.0 | – |
| HIV status | |||
| HIV-infected | 112 | 70.9 | – |
| HIV-negative | 39 | 24.7 | – |
| Unknown | 7 | 4.4 | – |
| Total | 158 | 100.0 | – |
| Type of X-ray | |||
| Chest | 152 | 95.6 | – |
| Spine | 6 | 3.8 | – |
| Unknown | 1 | 0.6 | – |
| Total | 159a | 100.0 | – |
| Diagnostic agreementb | |||
| Yes | 112 | 70.9 | 63.1–77.8 |
| No | 46 | 29.1 | 22.2–36.9 |
| Total | 158a,c | 100.0 | – |
| Image quality | |||
| Good | 133 | 83.6 | 77.0–89.0 |
| Poor | 26 | 16.4 | 11.0–23.0 |
| Total | 159a | 100.0 | – |
| Image interpretabilityd | |||
| Conclusive | 89 | 58.2 | 49.9–66.1 |
| Inconclusive | 64 | 41.8 | 33.9–50.1 |
| Total | 153a,e | 100.0 | – |
| Treatment | |||
| Consistent with radiologist's readingf | 133 | 85.3 | 78.7–90.4 |
| Consistent with reading by TDH clinical staffg | 23 | 14.7 | 9.6–21.3 |
| Total | 156a,h | 100.0 | – |
| Patient outcome | |||
| Improved with treatment | 99 | 65.1 | 57.0–72.7 |
| Unchanged with treatment | 0 | 0.0 | 0.0–2.4 |
| Death | 23 | 15.1 | 9.8–21.8 |
| Transfer | 30 | 19.7 | 13.7–27.0 |
| Total | 152a,i | 100.0 | – |
CI, confidence interval; HIV, human immunodeficiency virus; TDH, Thyolo District Hospital.
a One patient presented with two distinct medical conditions on hospital admissions five months apart.
b Whether the radiologist reported at least one diagnosis also proposed by clinical staff.
c Diagnostic agreement not documented for one case.
d Whether the radiographic image alone allowed for a definitive diagnosis.
e Image interpretability not documented for six cases.
f Clinical staff agreed with the radiologist’s diagnosis.
g Clinical staff reached a diagnosis that disagreed with the radiologist’s.
h Three patients lost to follow-up before treatment initiation.
i Outcome of seven patients unknown.