Peru – Active TB Case-finding in Transgender Populations
Transgender women in Peru face barriers to healthcare access and have increased vulnerability to TB due to stigma and comorbidities such as HIV. Targeted active case finding was implemented to improve TB detection in this population.
Community-based mobile brigades
Urban mobile brigades engaged transgender communities and collected sputum samples for molecular testing.
Using portable X-ray with AI
Portable chest X-ray units equipped with CAD4TB were deployed to areas where transgender populations lived.
X-ray–guided testing
Individuals with abnormal chest X-rays were referred for sputum testing using Xpert MTB/RIF Ultra.
Parallel screening strategies
Mobile sputum collection and AI-supported X-ray screening were implemented concurrently.
In July 2022, two strategies were implemented in Lima’s transgender population. During the first eight months,
- 381 transgender persons were approached by mobile brigades, 362 (95%) left a sputum sample, and 11 (3%) persons were diagnosed with TB.
- Among 111 transgender women approached by the portable X-ray team, 110 (99%) were evaluated.
- Abnormal X-ray results were detected for 34 (30%) individuals, of whom 33 (99%) were evaluated with sputum testing.
- 4 individuals (3.6% of those screened by radiography) were diagnosed with TB.
- In total, 12 (86%) of the 14 individuals diagnosed with TB started treatment.
- Both screening strategies diagnosed TB in about 3% of the transgender people evaluated, which is more than 10 times the estimated incidence in Peru (130 per 100,000).
- It is important to implement active TB case-finding in this vulnerable population using these strategies.
REFERENCE: Puma, A.D.V. (2023, November 15-18). Active TB screening in transgender populations [Conference session]. The Union World Conference on Lung Health 2023, Paris, France.