Uganda – Optimal threshold to improve TB diagnostic yield with Delft Light & CAD4TB
The Uganda National TB and Leprosy Program adopted WHO’s recommendation to use digital X-rays with CAD for systematic TB screening. This study aims to determine the optimal CAD4TB threshold score to improve TB diagnostic yield.
Deployment of portable X-ray systems
12 Delft Light portable digital X-ray systems with CAD4TB were deployed at health facilities and in communities.
Health worker training
Health workers were trained on X-ray operation and the TB screening algorithm.
X-ray–guided sputum collection
Sputum samples were collected from individuals with abnormal chest X-rays.
Confirmatory testing and treatment
TB-confirmed individuals were started on standard TB treatment.
- High TB diagnostic yield can be achieved with a CAD4TB threshold score of 50 or more, potentially saving X-pert tests.
- The national TB program should strengthen sputum testing for individuals with a CAD4TB score of 50 or more and consider a lower threshold for PLHIV to improve TB case detection.
REFERENCE: Burua, A. et al (2024, November 12-15). Improving the diagnostic yield of TB from screening using digital X-ray fitted with computer-aided detection software: Lessons from programmatic implementation in Uganda [Poster Presentation]. The Union World Conference on Lung Health, Bali, Indonesia.