Portable digital X-ray for TB pre-diagnosis screening in rural communities in Nigeria
OBJECTIVE: To assess the usefulness of portable digital X-ray, the Delft-Light Backpack (DLB) for TB active case-finding (ACF) in hard-to-reach Niger Delta communities using the WHO 3B TB screening/diagnosis algorithm.
DESIGN: DLB X-ray was used to screen all consenting eligible participants during community TB screening out-reaches in all hard-to-reach communities of Akwa Ibom and Cross River States in the Niger Delta, Nigeria. Participants with a CAD4TB (computer-aided detection for TB score) 60 had Xpert (sputum) and/or clinical (radiograph) assessment for TB diagnosis. Data from the project were analysed for this study.
RESULTS: A total of 8,230 participants (males: 47.2%, females: 52.8%) underwent TB screening and 1,140 (13.9%) presumptive TB cases were identified. The TB prevalence among all participants and among those with presumptive TB were respectively 1.2% and 8.6%. The number needed to screen was 84. Among people with presumptive TB, the proportion of males and females with confirmed TB was respectively 12.0% and 5.6% (P < 0.001).
CONCLUSION: TB screening using DLB X-ray during community-based ACF in hard-to-reach Niger Delta communities of Nigeria showed a high TB prevalence among participants. Nationwide deployment of the instrument in hard-to-reach areas is recommended.
Keywords: Delft Light Backpack; GeneXpert TB diagnosis; WHO 3B TB screening/diagnosis algorithm; community-based active TB case-finding; computer-aided detection for TB
Document Type: Research Article
Affiliations: 1: Technical Division, KNCV Tuberculosis Foundation Nigeria, Abuja, Nigeria 2: College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu State, Nigeria 3: National Tuberculosis, Leprosy and Buruli Ulcer Control Program, Federal Ministry of Health Public Health, Abuja, Nigeria 4: TB/HIV Unit, HIV/AIDS & TB Office USAID Nigeria, Abuja, Nigeria
Publication date: June 21, 2022
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