Digital Innovations for early case detection Печать
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Speed and accuracy of case detection are critical success factors in the fight against TB. If TB is detected early and treated, patients quickly become non-infectious and eventually cured. With a timely check for TB, an accurate diagnosis and access to treatment, TB can be controlled and diminished. dCXR/CAD in combination with Xpert MTB/RIF have the potential to effectively respond to this need for early case detection through for instance systematic screening programs.

New technologies that can shorten the diagnostic process and facilitate early detection will decrease morbidity, improve treatment outcomes and interrupt the transmission of TB. Chest X-ray (CXR) is widely established in TB prevention programmes in especially the western world, Asia and eastern Europe, but numerous factors complicate its use in low and medium resource countries.

Source: WHO 2009 report, 2007 figures and estimates

 

Innovations for New Diagnostic Pathways

Digital radiology simplifies the creation of a quality image to 2 mouse clicks provided that staff is correctly trained. Images are instantly available and can be diagnosed on distance using the internet or even mobile phone network connections. In addition, Computer Aided Diagnosis for TB of digital images sensitivity currently reaches 90% at 80% specificity in a low HIV positive risk group screening program in the Philippines. CAD4TB developers of Radboud University expect CAD specificity of chest images to rise as R&D continues. This makes digital CXR supported by CAD a rapid and relatively low cost triage tool for Xpert eligibility, enabling NTP’s to double diagnostic input at same budgetary input.


Case detection in children

It is more difficult to diagnose TB in children than in adults as they are less likely to have the classical signs and symptoms of the disease, like couch. Children have usually less bacilli in the sputum and the younger children often cannot produce a specimen for microscopy. Therefore CXR plays an important role in TB diagnosis in children. However, CAD is for the moment only available for individuals as from 15 years old, but CAD for minors is under development.