Role of routine abdominal ultrasonography in intensified tuberculosis case finding algorithms at HIV clinics in high TB burden settings

Table 5 Diagnostic criterion for probable and possible abdominal TB among cases already diagnosed and those newly diagnosed as TB at entry to HIV care

Abdominal ultrasound findings suggestive of TB^d	Number of abdominal TB cases (N = 200)^a
Abdominal ultrasound findings suggestive of TB^d	Already diagnosed with TB at another site at entry to HIV Clinic (N = 113^b / 340)	Newly diagnosed at entry to HIV clinic (N = 87^a,c / 91)
Probable abdominal TB cases (n = 97)
1. Two Major findings	2	4
2. One major with at least two minor findings	1	6
3. One major finding with at least two symptoms	1	31
4. USG findings in cases with microbiolgically confirmed TB at another site:
• Two major findings (n = 3) • One major & two minor findings (n = 4) • One major finding alone or with one minor finding/one symptom (n = 33) • Two minor findings with more than two symptoms (n = 3) • One minor finding (n = 9)	52	None of the abdominal TB cases in this group had TB at another site
Possible abdominal TB cases (n = 100)
1. One major finding	51	38
2. Two minor findings with at least two symptoms	6	5

^aThree cases of abdominal TB were treated on basis of unexplained fever/ abdominal pain with thickened bowel loops, however did not meet criterion of probable or possible TB
^bIncluded 239 cases with pulmonary TB and 101cases with extra pulmonary TB at another site
^cThere was no pulmonary TB or extra pulmonary TB at another site these cases
^dMajor USG findings suggestive of TB – 1) Multiple abdominal lymph nodes, more than 1.5 cm in size with areas of central necrosis seen as hypoechogenecity on USG, with or without evidence of matting 2) Ascitis. Minor USG findings suggestive of TB – 1) Thickened bowel loops 2) splenic microabscesses 3) hepatosplenomegaly

ISSN: 1471-2334