TB causes 40% of all HIV deaths worldwide, hence the leading killer of people living with HIV. Increasing rates of smear-negative TB and other non-TB chest diseases common in countries with HIV epidemics make Chest X-ray an increasingly important tool to detect TB and other lung diseases in HIV/AIDS patients. National TB and HIV/AIDS Programs can accelerate TB case detection and achieve substantial cost savings when introducing direct digital radiology to prevalence studies and programs as a replacement of old analog systems.

For NTP's covering remote areas where radiologists or pulmonologists are limited or not available at all, remote diagnosis of digital Chest X-ray images will bring a practical solution. Computer Aided Detection can support and automate chest image reading “off line” on a simple laptop or "in the cloud" through internet connectivity even in the most remote places. These two innovations open up new solutions for National TB and HIV/AIDS programs for early TB case detection. On the cost side savings per direct digital radiology system relative to old film based analogue cameras can be in excess of € 75.000 per year for high daily throughput (> 150 images) TB screening centres.

NTP challenge: a concrete case

A real life example of a central African NTP facing serious challenges to detect TB cases on time.
“Hampered by geographical inaccessibility (large distances, insufficient means of transport), the instability of trained personal, care provider strikes and poorly functioning links between treatment health centres (THCs) and diagnostic health centres (DHCs), the detection rate across the rest of the country remains poor. The detection rate is also low for smear-negative pulmonary cases (10%) and extrapulmonary tuberculosis (19%), stemming from a lack of adequate diagnostic equipment in the DHCs as only 167 out of 1,269 DHCs have functioning radiography equipment”.