{"id":{"repo_id":"cape-town","oai_identifier":"oai:open.uct.ac.za:11427/41979"},"canonical_url":"https://search.dev.ndltd.org/etd/cape-town/oai:open.uct.ac.za:11427/41979","repository":{"repo_id":"cape-town","name":"University of Cape Town","base_url":"https://open.uct.ac.za/oai/request"},"display":{"title":"Radiological predictors of PCP in HIV-positive adults in South Africa: a matched case-control study","abstract":"Definition of chest X-ray (CXR) features associated with laboratory-confirmed pneumocystis pneumonia (PCP) among HIV-positive adults is needed to improve diagnosis in high-burden settings. Methods: We conducted a case-control study involving HIV-positive adults with laboratory-confirmed PCP and a matched cohort with non-PCP respiratory presentations at regional hospitals in Cape Town, South Africa (2012 – 2020). The primary objective was to identify CXR features associated with confirmed PCP diagnosis and severe PCP (defined by hypoxia, ICU referral/admission, and/or in-hospital death). We explored the performance of logistic regression models, incorporating selected clinical and CXR predictors, for PCP diagnosis and severe PCP. Results: Records from 104 adults (52 PCP cases and 52 non-PCP controls) were included. Diffuse versus patchy ground glass opacification was associated with increased odds of PCP diagnosis (adjusted odd's ratio (aOR) 6.2, 95% confidence interval (CI) 1.6 – 28.9, p =0.01) and severe PCP (aOR 4.5, 95%CI 1.6 – 14.4, p =0.008). Consolidation was associated with severe PCP (aOR 3.3, 95%CI 1.2 –11.0, p =0.03) as was increasing ground glass zone involvement (aOR 2.1 for each one-unit increase in involved zone; 95% CI, 1.4 – 3.2, p = 0.0004). Models incorporating hypoxia (hypoxia model) or tachypnoea (respiratory rate model) with diffuse ground glass opacities, absence of pleural effusion or reticular/reticulonodular changes on CXR performed well in predicting PCP (area under the receiver operating characteristic curve 0.828 (hypoxia model) and 0.857 (respiratory rate model). Conclusions: CXR evaluation alongside bedside clinical information offers good accuracy for discriminating definite PCP from other HIV-associated respiratory diseases.","abstract_html":"Definition of chest X-ray (CXR) features associated with laboratory-confirmed pneumocystis pneumonia (PCP) among HIV-positive adults is needed to improve diagnosis in high-burden settings. Methods: We conducted a case-control study involving HIV-positive adults with laboratory-confirmed PCP and a matched cohort with non-PCP respiratory presentations at regional hospitals in Cape Town, South Africa (2012 – 2020). The primary objective was to identify CXR features associated with confirmed PCP diagnosis and severe PCP (defined by hypoxia, ICU referral/admission, and/or in-hospital death). We explored the performance of logistic regression models, incorporating selected clinical and CXR predictors, for PCP diagnosis and severe PCP. Results: Records from 104 adults (52 PCP cases and 52 non-PCP controls) were included. Diffuse versus patchy ground glass opacification was associated with increased odds of PCP diagnosis (adjusted odd's ratio (aOR) 6.2, 95% confidence interval (CI) 1.6 – 28.9, p =0.01) and severe PCP (aOR 4.5, 95%CI 1.6 – 14.4, p =0.008). Consolidation was associated with severe PCP (aOR 3.3, 95%CI 1.2 –11.0, p =0.03) as was increasing ground glass zone involvement (aOR 2.1 for each one-unit increase in involved zone; 95% CI, 1.4 – 3.2, p = 0.0004). Models incorporating hypoxia (hypoxia model) or tachypnoea (respiratory rate model) with diffuse ground glass opacities, absence of pleural effusion or reticular/reticulonodular changes on CXR performed well in predicting PCP (area under the receiver operating characteristic curve 0.828 (hypoxia model) and 0.857 (respiratory rate model). Conclusions: CXR evaluation alongside bedside clinical information offers good accuracy for discriminating definite PCP from other HIV-associated respiratory diseases.","abstract_has_math":false,"creators":["Wills, Nicola"],"institution":"Department of Medicine","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Wasserman, Sean"],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025","date_published":"2025","updated_at":"2026-07-22T22:23:22Z","subjects":["X-ray","HIV"],"languages":["en"],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/11427/41979","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Wasserman, Sean"]},{"key":"dc:creator","label":"Author","values":["Wills, Nicola"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2025-10-02T11:56:59Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2025-10-02T11:56:59Z"]},{"key":"dc:date.issued","label":"Date","values":["2025"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Department of Medicine"]},{"key":"dc:publisher.institution","label":"Dc Publisher Institution","values":["University of Cape Town"]},{"key":"dc:type","label":"Dc Type","values":["Thesis / Dissertation"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Masters","MMed"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["X-ray","HIV"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/11427/41979"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Definition of chest X-ray (CXR) features associated with laboratory-confirmed pneumocystis pneumonia (PCP) among HIV-positive adults is needed to improve diagnosis in high-burden settings. Methods: We conducted a case-control study involving HIV-positive adults with laboratory-confirmed PCP and a matched cohort with non-PCP respiratory presentations at regional hospitals in Cape Town, South Africa (2012 – 2020). The primary objective was to identify CXR features associated with confirmed PCP diagnosis and severe PCP (defined by hypoxia, ICU referral/admission, and/or in-hospital death). We explored the performance of logistic regression models, incorporating selected clinical and CXR predictors, for PCP diagnosis and severe PCP. Results: Records from 104 adults (52 PCP cases and 52 non-PCP controls) were included. Diffuse versus patchy ground glass opacification was associated with increased odds of PCP diagnosis (adjusted odd's ratio (aOR) 6.2, 95% confidence interval (CI) 1.6 – 28.9, p =0.01) and severe PCP (aOR 4.5, 95%CI 1.6 – 14.4, p =0.008). Consolidation was associated with severe PCP (aOR 3.3, 95%CI 1.2 –11.0, p =0.03) as was increasing ground glass zone involvement (aOR 2.1 for each one-unit increase in involved zone; 95% CI, 1.4 – 3.2, p = 0.0004). Models incorporating hypoxia (hypoxia model) or tachypnoea (respiratory rate model) with diffuse ground glass opacities, absence of pleural effusion or reticular/reticulonodular changes on CXR performed well in predicting PCP (area under the receiver operating characteristic curve 0.828 (hypoxia model) and 0.857 (respiratory rate model). Conclusions: CXR evaluation alongside bedside clinical information offers good accuracy for discriminating definite PCP from other HIV-associated respiratory diseases."]},{"key":"dc:title","label":"Title","values":["Radiological predictors of PCP in HIV-positive adults in South Africa: a matched case-control study"]}]}],"canonical_facts":{"dc:contributor.advisor":["Wasserman, Sean"],"dc:creator":["Wills, Nicola"],"dc:date.accessioned":["2025-10-02T11:56:59Z"],"dc:date.available":["2025-10-02T11:56:59Z"],"dc:date.issued":["2025"],"dc:description.abstract":["Definition of chest X-ray (CXR) features associated with laboratory-confirmed pneumocystis pneumonia (PCP) among HIV-positive adults is needed to improve diagnosis in high-burden settings. Methods: We conducted a case-control study involving HIV-positive adults with laboratory-confirmed PCP and a matched cohort with non-PCP respiratory presentations at regional hospitals in Cape Town, South Africa (2012 – 2020). The primary objective was to identify CXR features associated with confirmed PCP diagnosis and severe PCP (defined by hypoxia, ICU referral/admission, and/or in-hospital death). We explored the performance of logistic regression models, incorporating selected clinical and CXR predictors, for PCP diagnosis and severe PCP. Results: Records from 104 adults (52 PCP cases and 52 non-PCP controls) were included. Diffuse versus patchy ground glass opacification was associated with increased odds of PCP diagnosis (adjusted odd's ratio (aOR) 6.2, 95% confidence interval (CI) 1.6 – 28.9, p =0.01) and severe PCP (aOR 4.5, 95%CI 1.6 – 14.4, p =0.008). Consolidation was associated with severe PCP (aOR 3.3, 95%CI 1.2 –11.0, p =0.03) as was increasing ground glass zone involvement (aOR 2.1 for each one-unit increase in involved zone; 95% CI, 1.4 – 3.2, p = 0.0004). Models incorporating hypoxia (hypoxia model) or tachypnoea (respiratory rate model) with diffuse ground glass opacities, absence of pleural effusion or reticular/reticulonodular changes on CXR performed well in predicting PCP (area under the receiver operating characteristic curve 0.828 (hypoxia model) and 0.857 (respiratory rate model). Conclusions: CXR evaluation alongside bedside clinical information offers good accuracy for discriminating definite PCP from other HIV-associated respiratory diseases."],"dc:identifier.uri":["http://hdl.handle.net/11427/41979"],"dc:language.iso":["en"],"dc:publisher.department":["Department of Medicine"],"dc:publisher.institution":["University of Cape Town"],"dc:subject":["X-ray","HIV"],"dc:title":["Radiological predictors of PCP in HIV-positive adults in South Africa: a matched case-control study"],"dc:type":["Thesis / Dissertation"],"dc:type.qualificationlevel":["Masters","MMed"]},"updated_at":"2026-07-22T22:23:22Z"}