In Nigeria, TB screening in 17 prisons identified a high number of cases, highlighting the effectiveness of using digital X-rays with CAD4TB over traditional symptom screening. Discover the impact of this advanced approach in detecting and treating TB in prison populations, underscoring the need for regular screenings.

Location: Nigeria // Organisation: KNCV Nigeria, Delft Imaging.

TB screening was conducted in 17 prisons across 12 states in Nigeria. Following advocacy to the authorities, the prison health teams were trained to be part of the systematic TB screening intervention. The workflow specified the sequence for screening cell inmates. TB screening was done using portable digital X-rays or mobile clinics fitted with digital X-rays with CAD and GeneXpert, or by applying the WHO 4 symptom screening (W4SS). Samples were collected from identified presumptive TB and evaluated. Diagnosed TB patients were linked to treatment.

From January to August 2022, 26,615 inmates were screened, and 4,162 presumptive TB were identified (presumptive TB yield of 16%). Of those, 4,158 were evaluated, and 468 TB cases were diagnosed with a TB yield of 11%. Of the diagnosed TB cases, 456 (97.4%) were successfully enrolled on treatment.

There was a higher TB yield (17%) from screening done with the digital chest X-ray with CAD4TB compared to screening done with W4SS alone (TB yield of 5%).

Given the high yield of TB cases, it is inferable that prisons are hotspots for Tuberculosis. Three times more TB cases were diagnosed with digital X-ray screening with CAD4TB compared to W4SS. We propose routine biannual screening using Chest X-rays with AI in Nigerian penitentiary institutions.

REFERENCE: Chukwuogo, O. (2023, November 15-18). Yield from active TB case-finding activities in prisons: implications for routine TB screening in Nigerian penitentiary institutions [Conference session]. The Union World Conference on Lung Health 2023, Paris, France.