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A systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury
Background: HIV-associated tuberculosis has a high mortality. Chest x-rays are an adjunct diagnostic tool for tuberculosis but has high inter-reader variability, which may be reduced with chest x-ray scoring systems. We analysed and scored chest x-rays of hospitalised patients with HIV-associated tu...
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| Format: | Thesis |
| Language: | English English |
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Department of Public Health and Family Medicine
2025
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| _version_ | 1867613258494509056 |
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| access_status_str | Open Access |
| author | Vermeulen, Marcia |
| author2 | Schutz, Charlotte |
| author_browse | Schutz, Charlotte Vermeulen, Marcia |
| author_facet | Schutz, Charlotte Vermeulen, Marcia |
| author_sort | Vermeulen, Marcia |
| collection | Thesis |
| description | Background: HIV-associated tuberculosis has a high mortality. Chest x-rays are an adjunct diagnostic tool for tuberculosis but has high inter-reader variability, which may be reduced with chest x-ray scoring systems. We analysed and scored chest x-rays of hospitalised patients with HIV-associated tuberculosis and assessed the relationship of these chest x-ray scores with 12-week mortality and biomarkers of tuberculosis dissemination. Methods: In this cohort study, the chest x-rays of adult patients, admitted with a new diagnosis of microbiologically confirmed HIV-associated tuberculosis were scored using the Timika scoring system. We excluded patients without a valid test result for the 3 biomarkers of tuberculosis dissemination (urine lipoarabinomannan, TB blood culture and urine Xpert); valid chest x-ray; or who were lost to follow up. Results: Amongst 364 included participants, 73 (20%) died and 291 (80%) survived. Median age was 36 years and median CD4 count 57cells/mm3. 25% of participants had normal chest x-rays. No association was found between chest x-ray score and dissemination score. Higher chest x-ray score was associated with higher hazards of death using a multivariate analysis: every 10-point increase in chest x-ray score resulted in 9% increased hazards of death. Conclusion: In this cohort, a higher Timika chest x-ray score was associated with higher hazards of death at 12-weeks. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/41941 |
| institution | University of Cape Town (South Africa) |
| language | English eng |
| last_indexed | 2026-06-10T12:33:17.409Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Department of Public Health and Family Medicine |
| publisherStr | Department of Public Health and Family Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/41941 A systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury Vermeulen, Marcia Schutz, Charlotte Meintjes, Graeme TB HIV Background: HIV-associated tuberculosis has a high mortality. Chest x-rays are an adjunct diagnostic tool for tuberculosis but has high inter-reader variability, which may be reduced with chest x-ray scoring systems. We analysed and scored chest x-rays of hospitalised patients with HIV-associated tuberculosis and assessed the relationship of these chest x-ray scores with 12-week mortality and biomarkers of tuberculosis dissemination. Methods: In this cohort study, the chest x-rays of adult patients, admitted with a new diagnosis of microbiologically confirmed HIV-associated tuberculosis were scored using the Timika scoring system. We excluded patients without a valid test result for the 3 biomarkers of tuberculosis dissemination (urine lipoarabinomannan, TB blood culture and urine Xpert); valid chest x-ray; or who were lost to follow up. Results: Amongst 364 included participants, 73 (20%) died and 291 (80%) survived. Median age was 36 years and median CD4 count 57cells/mm3. 25% of participants had normal chest x-rays. No association was found between chest x-ray score and dissemination score. Higher chest x-ray score was associated with higher hazards of death using a multivariate analysis: every 10-point increase in chest x-ray score resulted in 9% increased hazards of death. Conclusion: In this cohort, a higher Timika chest x-ray score was associated with higher hazards of death at 12-weeks. 2025-10-01T12:06:17Z 2025-10-01T12:06:17Z 2025 2025-10-01T09:18:27Z Thesis / Dissertation Masters MPH http://hdl.handle.net/11427/41941 en eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences University of Cape Town |
| spellingShingle | TB HIV Vermeulen, Marcia A systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury |
| thesis_degree_str | Master's |
| title | A systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury |
| title_full | A systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury |
| title_fullStr | A systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury |
| title_full_unstemmed | A systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury |
| title_short | A systematic review: the role of neuroinflammation as a pathway to injury in traumatic brain injury |
| title_sort | systematic review the role of neuroinflammation as a pathway to injury in traumatic brain injury |
| topic | TB HIV |
| url | http://hdl.handle.net/11427/41941 |
| work_keys_str_mv | AT vermeulenmarcia asystematicreviewtheroleofneuroinflammationasapathwaytoinjuryintraumaticbraininjury AT vermeulenmarcia systematicreviewtheroleofneuroinflammationasapathwaytoinjuryintraumaticbraininjury |