The e-Prevalence survey platform responds to the growing need for monitoring of national TB program effectiveness and SDG achievement. The e-Prevalence survey platform - first proposed by CheckTB! to the NTP of Ghana - allows all participant data to be merged in one electronic file that can be sent over any mobile phone network to a central database. e-Prevalence significantly reduces survey cost and time to complete, increases data quality & integrity and therefore sets new standards.
A typical survey in a TB high burden setting reaches a sample size of 50,000- 80,000 and a cluster size of 500-800. Typically 12-15 staff members are needed per field team for 6–10 months with 3-4 teams in operation. Average costs of traditional surveys are estimated at US$ 2-3 million including Capital Investment (CXR, Lab, Cars), Human Resource (salaries), Survey Operation (Field and Central), Pre & Post survey events, technical assistance. Innovations in e-prevalence to support data collection and Chest X-ray Imaging allow for significant reductions in operational cost and lead time.
Pre-conditions for e-Prevalence survey:
- Use proven IT technology, mobile phone network and stable PACS software
- Full electronic (from questionnaire to final report)
- Use PDA's to capture patient details, perform questionnaires and print barcode labels
- Full patient data must be retained for patient follow-up should TB be detected
- Only specific details in prevalence survey data - Age, Sex, Region, etc
- Digital Chest X-ray (DR) & PACS with quality image compression
- Participant data and digital Chest X-ray to be sent automatically via mobile phone or satellite network
- Computer Aided Detection - to be used as a second opinion on site or 3rd reading of the X-ray
e-prevalence survey process

 
Commonly used in high burden countries WHO/STOP TB: Strategy 3
Start
- Participant data collected on site electronically with PDA entering automatically into the central database and printing a unique barcode
- Questionnaire (downloading from 1) all applicable c.q. permitted personal data); selection menu for scoring and automated counting of result
- On site make digital Chest X-ray (downloading from 1) all applicable c.q. permitted personal data, including the CRRS and related reading results on site)
- Automatic back-up on local computer workstation and forwarding of the participant file including questionnaire and compressed CXR over 3G network to central database for data consolidation and centralised 2nd reading of the CXR
- Fill out fields for smear microscopy and culture results if applicable
End
e-prevalence survey platform
In below graph the all electronic platform for TB prevalence surveys is illustrated. This set-up has already been successfully in operation in TB screening programs of European TB programs.

Prevalence survey differences | Analogue | Digital |
Electronic participant data collection
|
no |
yes
|
Electronic questionnaire and scoring |
no |
yes |
Barcoding for unique participant ID |
no |
yes |
High CXR readability/image quality
|
no |
yes |
CXR image cost (per throughput) |
€ 2.50 - 3.50 |
€ 0.30 - 1.25 |
Immediate image availability
|
no
|
yes |
Picture Archiving & Communication System |
no |
yes |
Electronic data management & privacy tools
|
no |
yes |
Film & chemical elimination
|
no |
yes |
Remote & Computer Aided CXR reading |
no |
yes |
Automated data back-up
|
no |
yes |
|