Predicting pulmonary tuberculosis in immigrants: a retrospective cohort study

Area of Science:

• Medical Diagnostics
• Infectious Diseases
• Public Health

Background:

• Pulmonary tuberculosis (PTB) poses a diagnostic challenge, particularly in immigrant populations.
• Early prediction of PTB is crucial for effective management and control.

Purpose of the Study:

• To determine if PTB can be predicted in immigrants using targeted medical history and basic laboratory tests.
• To assess the predictive value of specific clinical and laboratory features for PTB.

Main Methods:

• Retrospective cohort study of 391 foreign-born adults referred to a tuberculosis clinic.
• Multiple logistic regression analysis and cross-validation were employed.
• Receiver operating characteristic (ROC) curves and area under the curve (AUC) quantified model performance for culture-positive and smear-positive outcomes.

Main Results:

• Symptoms, subacute symptom duration, TB reactivation risk factors, and anemia predicted culture-positive PTB (AUC=0.91).
• Symptoms, broad-spectrum antibiotic use, and typical chest radiograph findings predicted smear-positive PTB (AUC=0.94).
• Predictive models demonstrated high accuracy.

Conclusions:

• PTB in foreign-born individuals is predictable using targeted medical history and basic laboratory data.
• These findings can enhance diagnostic suspicion in low-prevalence settings.
• A targeted approach aids in early identification and management of PTB in immigrants.