Ultrasound in Managing Tuberculosis: A randomized controlled two-center study

In resource limited settings with high tuberculosis (TB) prevalence, almost half of patients are treated upon clinical suspicion only. Besides challenges in availability of microbiological tests, poor sensitivity of these is a major reason for empiric treatment, especially in patients co-infected with HIV or patients suspected of extrapulmonary TB (EPTB).

The consequence is an overtreatment in patients, who might suffer from diseases other than TB. Small studies showed that focused Assessment with Sonography for HIV and Tuberculosis (FASH) might be useful to detect signs of EPTB. Moreover, other diseases with similar symptoms as TB can be detected by Sonography (Ultrasound). Ultrasound might therefore increase the proportion of correctly managed patients (i.e patients who have TB receive anti TB treatment, whereas patients will be higher in the intervention group than in the control group (85% vs 73%).

The objective of thios study is to assess the impact of Sonography on the proportion of correctly managed patients with the suspected EPTB and morbidity and mortality in a a randomized control trial in 2 centers (St Francis Referral Hospital, IHI Ifakara, TB Clinic , Mwananyamala Hospital). Patients will be managed according a predefined algorithm including Sonography in the intervention arm and according state of the art in the control group.#