Comparative analysis of the impact of portable digital X-ray on TB screening in hard-to-reach areas in Nigeria.

IF 1.3 Q4 RESPIRATORY SYSTEM

Public Health Action Pub Date : 2025-03-01 DOI:10.5588/pha.24.0040

S Useni, B Odume, M Tukur, E Chukwu, N Nwokoye, C Ogbudebe, O Chukwuogo, U Osuoji, C Igwetu, I Gordon, D Nongo, R Eneogu, A Ihesie, O Chukwuekezie, C Anyaike, M Y Diul

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Abstract

Setting: TB screening cascade and performance of active case-finding strategies across six states of Nigeria.

Objective: To analyse the impact of portable digital X-ray (PDX) on TB screening in hard-to-reach areas in Nigeria.

Design: A cross-sectional study involving enrollees with a CAD4TB score of ≥50 had Xpert (sputum) and/or radiographic assessment for TB diagnosis. A TB screening algorithm guided the step-by-step process of identifying a presumptive TB client up to diagnosis and linkage for appropriate treatment. Data were collected, collated, and reported using the national TB tools.

Results: Seven PDX with CAD4TB used as TB screening and diagnostic tools across six states screened 85,910 persons and identified 8,416 presumptive TB cases. From this study, PDX had the lowest number needed to screen (NNS) of 45 and the number needed to test (NNT) of 4. Similarly, PDX, with a presumptive TB yield of 10%, had the highest TB yield of 23%.

Conclusion: Using PDX with CAD contributed to the highest TB yield during Active TB case finding in hard-to-communities of Nigeria. With a very low NNS and NNT, its national scale-up and use across remote locations will significantly improve TB case-finding.

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环境：目标：分析便携式数字 X 光（PDX）对尼日利亚难以到达地区结核病筛查的影响：分析便携式数字 X 光（PDX）对尼日利亚难以到达地区结核病筛查的影响：设计：一项横断面研究，对 CAD4TB 得分≥50 分的参试者进行 Xpert（痰）和/或放射学评估，以诊断肺结核。在结核病筛查算法的指导下，逐步确定推定的结核病患者，直至确诊并联系适当的治疗。使用国家结核病工具收集、整理和报告数据：结果：六个州的七个 PDX 使用 CAD4TB 作为结核病筛查和诊断工具，筛查了 85,910 人，发现了 8,416 个推定结核病例。在这项研究中，PDX 的筛查所需人数（NNS）最低，为 45 人，检测所需人数（NNT）为 4 人。同样，PDX 的推定肺结核发病率为 10%，而肺结核发病率最高，为 23%：结论：在尼日利亚难以进入的社区进行主动结核病病例发现时，使用 PDX 和 CAD 可获得最高的结核病检出率。由于其 NNS 和 NNT 很低，在全国推广并在偏远地区使用将大大提高结核病病例发现率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Public Health Action RESPIRATORY SYSTEM-

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期刊介绍： Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.