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Open Access Early TB case detection by community-based mobile X-ray screening and Xpert testing in Balochistan

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Authors: Wali, A. 1 ; Safdar, N. 2 ; Manair, R. 3 ; Khan, M. D. 4 ; Khan, A. 5 ; Kurd, S. A. 6 ; Khalil, L. 7 ; 

Source: Public Health Action, Volume 11, Number 4, 21 December 2021, pp. 174-179(6)

Publisher: International Union Against Tuberculosis and Lung Disease

DOI: https://doi.org/10.5588/pha.21.0050

SETTING: This survey was conducted at 35 sites of 20 cities in 15 districts with low programmatic TB case notifications in the past years in Balochistan.

OBJECTIVE: To assess the effectiveness of the systemic community-based screening and diagnosis for early detection of TB; and 2) to describe the characteristics and understand the strengths and weaknesses of the intervention in Balochistan, and sociodemographic factors associated with it.

DESIGN: This cross-sectional descriptive study was conducted using a mobile van equipped with a digital X-ray machine with computer-aided detection for TB (CAD4TB) software for screening, followed by confirmatory high sensitivity Xpert® MTB/RIF assay testing.

RESULTS: A total of 236 (3.4%) TB cases was detected out of 6,899 screened. About 1,168 (17%) presumptive TB cases were identified and 1,065 (91%) sputum samples were tested on Xpert. Among those diagnosed, 166 (70%) were Mycobacterium tuberculosis-positive and 70 (30%) were with clinical suspicion. Of the sputum samples tested, 87% (923/1065) had a probability score of >70 on CAD4TB.

CONCLUSION: Community-based screening with innovative activities, comprising sensitive screening and diagnostic tools, effectively improves TB case detection, which might suffice to reduce the prevalence of TB and break the chain of infection transmission in the at-risk population.

Keywords: CAD4TB; MTB/RIF assay; community-based; screening; tuberculosis

Document Type: Research Article

Affiliations: 1: Department of Primary and Secondary Healthcare, Government of Balochistan, Quetta, Pakistan, Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway 2: Interactive Research and Development, Singapore 3: Interactive Research and Development, Karachi, Pakistan 4: Provincial AIDS Control Programme, Department of Primary and Secondary Healthcare, Government of Balochistan, Quetta, Pakistan 5: Planning and Development Department, Government of Balochistan, Quetta, Pakistan 6: Vector-Borne Disease Control Programme, Department of Primary and Secondary Healthcare, Government of Balochistan, Quetta, Pakistan 7: Human Resource Development, Department of Primary and Secondary Healthcare, Government of Balochistan, Quetta, Pakistan

Publication date: December 21, 2021

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  • Public Health Action (PHA), The Union's quarterly Open Access journal, welcomes the submission of articles on operational research. It publishes high-quality scientific research on health services, providing new knowledge on how to improve access, equity, quality and efficiency of health systems and services.

    The Editors will consider any manuscript reporting original research on quality improvements, cost-benefit analysis, legislation, training and capacity building, with a focus on all relevant areas of public health (e.g. infection control, nutrition, TB, HIV, vaccines, smoking, COVID-19, microbial resistance, outbreaks etc).

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