The TB volume sweep research protocols have received approval and ethical clearance under the stewardship of Prof. Health Zar, Chief Paediatrician at Red Cross War Memorial Children's Hospital and Chair Professor of Pediatrics at the University of Cape Town. The project will roll out in the Red Cross War Memorial Children’s Hospital (image right), nested within a larger HIV-TB project.
A pilot study previously conducted in Johannesburg’s Chris Hani Baragwanath Hospital by Dr. Tsepo Moseme and Savvas Andronikou in 2013 has already shown that sonography of the mediastinum is a feasible, reliable, non-invasive method which is able to detect mediastinal lymphadenopathy in children with suspected primary pulmonary tuberculsos. As such it provides an alternative POC diagnostic test in the diagnosis of pediatric TB. This preliminary paper is accepted for publication in the Pediatric Radiology journal.
This WFPI TB volume sweep research project will determine quality of transferred information; compare volume sweep diagnosis against a gold standard US examination and compare the US detection of lymphadenopathy against plain radiography while taking other definitive diagnostic tests into account. There is also an associated TB MRI project run by Dr. Tanyia Pillay (SASPI) with Savvas Anrdonikou, which can serve as a gold standard for a proportion of the patients.
Any child suspected of TB will receive all the standard diagnostic tests, followed by abdominal US performed by a trained sonographer. The patient will then receive a mediastinal volume sweep, ITW-style, performed by a blinded non-radiologist healthcare worker with no prior US experience, followed by a chest CXR, and in a subgroup, MRI of the chest.
1. To evaluate volume sweeps for quality (procedural and demonstration of anatomy) – sent by email to radiologists in USA and South Africa
2. To compare to volume sweeps against gold standard US for detection of lymphadenopathy
3. Compare gold standard mediastinal US against abdominal US, chest radiographs and MRI
Renal and head US projects can also be performed in South Africa or alternatively in the USA, Europe or elsewhere as they do not require TB patients.