Case Study

Nigeria – ACF targeting most-at-risk and hard-to-reach populations

CAD4TB in Nigeria

A parallel screening approach combining the WHO four-symptom screen and chest X-ray with CAD4TB improved TB detection among hard-to-reach and most-at-risk populations in Nigeria. The intervention demonstrated high efficiency in identifying and treating TB cases and showed strong potential for scale-up.

Setting: hard-to-risk areas

Targeted active case finding was implemented to reach most-at-risk and hard-to-reach populations and improve TB detection.

Screening with X-ray and AI

A parallel screening algorithm combined the WHO four-symptom screen with chest X-ray supported by CAD4TB.

Advanced diagnostic evaluation

Presumptive TB cases were evaluated using GeneXpert, Truenat, or TB LAMP for bacteriological confirmation.

Review of Xpert-negative cases

Chest X-rays and symptoms from bacteriologically negative cases were reviewed by radiologists to support diagnosis.

Result

Between December 2021 to March 2022, 17,261 (Male: 12,350, Female: 4,911) were screened for TB,

2 ,784 people
identified as presumptive TB
2 ,693 people
evaluated using confirmatory diagnostics
43 7 TB cases diagnosed
were enrolled in treatment
CAD4TB in Nigeria
Conclusion
  • Deploying Delft Light with CAD4TB improved access to TB screening among hard-to-reach and most-at-risk populations, including men.
  • The intervention proved efficient in identifying missing TB cases through parallel screening and clinical review.
  • This approach is recommended for scale-up to additional states in Nigeria to strengthen TB case detection and treatment coverage.

REFERENCE: B. Odume et al. (2022, November 8-11). Delft Light Backpack (DLB) portable digital X-ray for pre-diagnostic TB screening: results from a scale-up intervention in Nigeria. The Union World Conference on Lung Health 2022.