Case Study

Pakistan – Active case finding at prison with CAD4TB

People are waiting in line in front of the mobile clinics to have the chest X-ray scan in Pakistan

Systematic TB screening in prison settings using portable digital X-ray with CAD4TB identified a high number of presumptive TB cases. The findings confirm prisons as high-risk environments and highlight the value of technology-enabled mass screening to reduce TB transmission.

High-risk prison setting

Prisons were identified as high-risk environments for TB transmission.

Need for systematic screening

TB prevalence in prisons is significantly higher than the national average.

Using portable X-ray and CAD4TB

Active TB screening was conducted using portable digital X-ray systems with CAD4TB.

AI-supported identification

Presumptive TB cases were identified using CAD4TB scores and symptom screening.

Result

Prison screening period

20 ,557 inmates
were screened
1 ,964 (10%) inmates
identified as presumptive TB
  • The presumptive TB cases were identified with a CAD4TB score ≥70 and/or as being symptomatic.
  • TB prevalence at prisons is around 1.8 times higher than the estimated national prevalence.
A summary table of the TB screening result in Pakistan
Conclusion
  • TB screening is necessary at prisons as part of routine practice and use of technology enables mass screening and higher yields of MTB cases, reducing transmission.

REFERENCE: The 52nd UNION conference “Active case-finding using artificial intelligence in prison facilities in Karachi, Quetta and Peshawar, Pakistan”, Maniar et al., Indus Hospital and Health Network.