title: An evaluation of chest X-ray in the context of community-based screening of child tuberculosis contacts.
abstract: BACKGROUND
  There are no published data on the critical review of chest X-ray (CXR) findings of children in the context of community-based contact screening.
  
  
  OBJECTIVE
  To describe the quality, findings and inter-observer agreement of CXRs in child TB contacts in Indonesia.
  
  
  METHODS
  We performed antero-posterior (AP) and lateral CXR in children who had had close contact with a pulmonary TB case. The CXRs were interpreted independently by four reviewers.
  
  
  RESULTS
  A total of 530 CXRs of 265 children were reviewed. Most (63%) of the children were asymptomatic at the time of CXR. Only 60% of the CXRs were reported as moderate to good quality by all reviewers, and inter-observer agreement on quality was slight to moderate (weighted κ = 0.16-0.35) for AP view. The majority of the CXRs were reported as normal (range 65-77%), with fair to moderate inter-observer agreement (κ = 0.25-0.46). Hilar lymphadenopathy (6-16%) was the most common CXR abnormality reported with poor inter-observer agreement (κ = -0.03 to 0.25).
  
  
  CONCLUSIONS
  The CXRs of child TB contacts investigated in the community were characterised by low quality, low agreement and low yield. Our findings support guidelines that CXR is not routinely indicated in asymptomatic child TB contacts in this setting.
authors.affiliation: Department of Paediatrics, Faculty of Medicine, Dr Sardjito Hospital, Universitas Gadjah Mada, Yogyakarta, Indonesia; Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Children's Research Institute, Victoria, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Triasih
authors.affiliation: Department of Respiratory Medicine and University of Melbourne, Victoria, Australia.
authors.forename: C
authors.initials: C
authors.lastname: Robertson
authors.affiliation: Department of Radiology and University of Melbourne, Royal Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: J
authors.initials: J
authors.lastname: de Campo
authors.affiliation: Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Children's Research Institute, Victoria, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Duke
authors.affiliation: Department of Radiology, Dr Sardjito Hospital/Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia.
authors.forename: L
authors.initials: L
authors.lastname: Choridah
authors.affiliation: Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Children's Research Institute, Victoria, Australia; International Union Against Tuberculosis and Lung Disease, Paris, France.
authors.forename: S M
authors.initials: SM
authors.lastname: Graham
mesh_terms: D002648:Child; D002675:Child, Preschool; D016358:Contact Tracing; D005260:Female; D006801:Humans; D007214:Indonesia; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011446:Prospective Studies; D013902:Radiography, Thoracic; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging*