Abstract
Background
To meet incidence reduction goals, the Global Plan to End TB 2023-30 emphasises for the first time that detection of subclinical TB is a priority. WHO Systematic Screening guidelines (2021) have stressed the importance of CXR as a screening tool to achieve this including recommending the use of Computer Aided Detection (CAD) technology.
Methods
We conducted a cross-sectional survey of National TB Programmes who reported >1000 TB cases annually. The questions aligned with 2021 WHO screening guidelines and aimed to understand country’s practices, policies, and challenges when screening for TB disease.
Results
Sixty of 123 invited countries responded representing 82% of the global TB burden. Only 66% carried out all 6 WHO-recommended steps to implement screening and 39% collected all 7 of the WHO-recommended datapoints for monitoring activity. Although most countries had a policy for using CXR and increasing CXR-based screening (77% and 68% respectively), 90% reported at least one significant barrier to implementing this and 92% reported at least one barrier to implementing CAD technology.
Conclusion
Many countries do not carry out all recommended steps for implementation and monitoring of TB screening and although CXR and CAD use are expanding and hold promise as tools to find people with TB, many programmes do not have adequate access to them. While global policy is in place that recommends the use of these tools more efforts should be made to support countries in tackling the barriers that prohibit implementation to make sure that we can close the TB case finding gap.