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Case Study

Nigeria – Bi-directional screening with OneStopTB Mobile Clinic & CAD4TB

Health workers, community leaders, and partners posing in front of the Wellness on Wheels mobile TB screening clinic in Nigeria, in partnership with USAID, KNCV Tuberculosis Foundation, and Challenge TB.

The “WoW” truck’s integrated testing approach, highlighted in a WHO case study, showcased its effectiveness in TB, COVID-19, and HIV screening, diagnosing multiple cases across these diseases. This model provided crucial early diagnosis and treatment linkage, demonstrating a successful strategy for addressing concurrent health challenges in communities.

Deployed for community screening

The “WoW” truck, was deployed to provide integrated TB, COVID-19, and HIV screening during community outreach activities.

Digital X-ray with AI

All participants were screened using digital chest X-ray supported by CAD4TB to identify individuals with presumptive tuberculosis.

Confirmatory molecular testing

Individuals identified as presumptive TB cases were referred for bacteriological confirmation using GeneXpert.

Multi-disease approach

In parallel, participants were offered SARS-CoV-2 testing using nasopharyngeal swabs and HIV screening, enabling a single-entry point for multiple priority diseases.

Result

Between June and July 2020, 1,931 individuals were enrolled. Of these:

1 ,928 people
were screened using CAD4TB
8 3 presumptive TB cases
were identified
1 1 TB cases
were diagnosed with GeneXpert
  • Among the persons screened, 1,252 nasopharyngeal swabs were collected and tested for SARS COV-2 and all were screened for HIV.
  • 183 (15%) COVID-19 and 12 (1.0%) HIV cases were diagnosed. The COVID-19/HIV co-infection rate was 0.5% and COVID/TB co-infection rate was 0%.
A health worker guiding a community member into the Wellness on Wheels mobile clinic for TB screening outside a town hall in Nigeria.
Conclusion
  • Integrated mobile screening using digital X-ray with CAD4TB enables early identification of TB while supporting simultaneous testing for other priority diseases.
  • The OneStopTB Mobile Clinic model improves access to diagnosis and facilitates timely linkage to treatment for TB and COVID-19 at the community level.
  • This multi-disease, community-based approach demonstrates a scalable strategy for strengthening early case finding and health system responsiveness in public health emergencies.

REFERENCE: “Using CAD in bi-directional screening”, Dr Bethrand Odume (KNCV Nigeria) presented at Delft Imaging’s Webinar on 30th June 2021. Gidado et al., “Early experience in implementation of an integrated covid-19 and TB community-based active case finding in Nigeria”, researchgate, October 2020.