Ogbole GI, Agunloye AM, Adeyinka AO
Routine chest radiographic examinations are usually performed for newly admitted students in Nigerian universities as a screening test for pulmonary tube rculosis (PTB). Such practice and their alleged benefits have generated a lot of controversy. The e vidence in favour of a non-selective screening for PTB using chest radiography in young asymptomatic s ubjects is extremely meagre. We evaluated this practice in Nigeria’s first and largest university. The chest radiographs of all consecutive newly admitted students taken over a 3-month period, betw een February and April 2011, were reviewed. All radiographs were read and classified as “normal” or “abnormal”. The abnormal radiographs were then further classified based on standard radiological c riteria on whether or not the abnormal lesions were indicative of PTB. 1021 chest radiographs were revi ewed. Of these, 572 (56%) radiographs were obtained in males and 449 (44%) in females. The sub jects’ ages ranged from 16 to 53 years (mean 26.1±8.9 years).151 radiographs (14.8 %) were repor ted as abnormal on the basis of presence of an incidental finding or a clinically relevant radiogr aphic abnormality. The students with an abnormal radiograph were about 8 years above the mean age fo r the normal group (P=0.001), but gender distribution was similar to the normal group. Detec ted abnormalities were categorized as affecting the heart (49, 4.8%), the bones (44, 4.3%), the lung (4 1, 4.0%), the diaphragm (9, 0.9%) or other structur es (8, 0.8%). None of the detected lesions was clinically severe, except for a single case of suspected aorti c aneurysm. Only 2.8% (29/1021) showed lesions compat ible with PTB. Newly admitted students at our institution undergo routine chest radiography with a low positive yield for infectious PTB or any othe r clinically significant incidental findings. The cur rent guidelines may require a review to ensure more efficient use of available resources and avoid unwa rranted radiation exposure.
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