Ethiopia – Improving TB diagnosis using CAD4TB and Stool Xpert testing
Ethiopia remains among the countries with the higest tuberculosis and TB/HIV burden globally. Early diagnosis is particularly challenging among household contacts who are unable to product sputum. Innovative screening approaches combining CAD4TB and chest radiography with non-respiratory molecular testing may help close these diagnostic gaps.
A prospective diagnostic accuracy study was conducted among tuberculosis index patients and their household contacts at a referral hospital in Oromia.
Participants underwent digital chest X-ray screening with CAD4TB support and provided stool and sputum samples for Xpert MTB/RIF testing.
CAD4TB demonstrated strong diagnostic performance
- Performance was higher in adults than in children.
- Stool Xpert testing showed high agreement with sputum Xpert results, enabling microbiological confirmation among individuals unable to expectorate.
- Over 10% of household contacts were newly diagnosed with TB.
- Combining CAD4TB with stool-based molecular testing improves TB detection among household contacts in high-burden, low-resource settings.
- This integrated approach is particularly valuable for children and others unable to produce sputum, and where access to radiological expertise is limited.
REFERENCE: Guido G. et al (2026). Improving Tuberculosis Diagnosis Through Artificial Intelligence (CAD4TB) and Stool Xpert MTB/RIF Testing: A Prospective Study from Oromia, Ethiopia. Open Forum Infectious Diseases.