Automated chest radiography and mass systematic screening for tuberculosis
METHOD: Screening was undertaken using mobile digital X-ray vehicles at hospital facilities and community camps. Chest X-rays were offered to individuals aged ≥15 years, regardless of symptoms. Those with a CAD4TB score of ≥70 were offered Xpert testing. The association between Xpert positivity and CAD4TB scores was examined using data collected between 1 January and 30 June 2018 using a custom-built data collection tool.
RESULTS: Of the 127 062 individuals screened, 97.2% had a valid CAD4TB score; 11 184 (9.1%) individuals had a CAD4TB score ≥70. Prevalence of Xpert positivity rose from 0.7% in the <50 category to 23.5% in the >90 category. The strong linear association between CAD4TB score and Xpert positivity was found in both community and hospital settings.
CONCLUSION: The strong association between CAD4TB scores and Xpert positivity provide evidence that an ACR-based pre-screening performs well when implemented at scale in a high-burden setting.
Document Type: Research Article
Affiliations: 1: Global Health Directorate, Indus Health Network, Karachi, Pakistan 2: Provincial TB Control Program, Department of Health, Government of Sindh, Hyderabad, Pakistan 3: Interactive Research and Development, Singapore 4: Global Health Directorate, Indus Health Network, Karachi, Pakistan, Interactive Research and Development, Singapore 5: Interactive Research and Development, Singapore, Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, United Kingdom
Publication date: July 1, 2020
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