Article Type

Original Research

Publication Date





Purpose: This article describes the process of training medical providers of different backgrounds about the “focused assessment with sonography for HIV-associated TB” (FASH) exam to expand the availability of ultrasound for TB diagnosis in resource poor settings in the central region of Malawi.

Methods and Materials: A survey was completed by the 19 eligible participants before and after a 4-day training course regarding the utility of the FASH exam. A six-question quiz was used to assess knowledge of the use of ultrasound in the FASH exam before and after the course.

Results: Participants’ knowledge of the FASH technique significantly improved after the four-day course with a 32% increase in total quiz questions answered correctly (p < 0.001). Ninety-five percent (n= 18) of participants answered that they would “likely” incorporate FASH in their clinical practice. Furthermore, 100% (n=19) of participants agreed that the FASH exam would improve their ability to diagnose TB and 95% (n=18) agreed that FASH would improve patient care in their clinic.

Conclusions: After completing a 4-day training course, medical providers were more knowledgeable about the FASH exam and its findings, and felt more comfortable using ultrasound for the diagnosis of TB. Participants were also unanimous in opinion that the FASH ultrasound exam would improve their ability to diagnose TB.


Radiology, ultrasound, tuberculosis, global health

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© 2018 the Author(s). This open access article is distributed under a Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/).

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.


The authors gratefully acknowledge all the patients and providers who participated in this project. We are thankful to the Lilongwe-based EQUIP-Malawi staff for providing administration and oversight for this project. We are also grateful to the following colleagues who have contributed their expertise to this project: Tom Heller, Sabine Belard, Ines Boechat, Jonathan Goldin, and Grace Kim. This research was made possible with support from funding provided by the President’s Emergency Plan for AIDS Relief (PEPFAR) through USAID-Malawi under the terms of Grant No. 674-A-00-10-00035-00.

Article Correction History

The PDF version of this article was corrected on March 30, 2018 to correct minor formatting errors.

Corresponding Author(s)

Kara-Lee Pool, MD, Department of Radiological Sciences, David Geffen School of Medicine at UCLA, UCLA Medical Center, 757 Westwood Blvd., Los Angeles, CA 90095-7437, USA; kpool@mednet.ucla.edu