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. 2021 Sep 4;6(3):163.
doi: 10.3390/tropicalmed6030163.

Early Evaluation of an Ultra-Portable X-ray System for Tuberculosis Active Case Finding

Luan Nguyen Quang Vo  1 , Andrew Codlin  1 , Thuc Doan Ngo  2 , Thang Phuoc Dao  2 , Thuy Thi Thu Dong  1 , Huong Thi Lan Mo  2 , Rachel Forse  1 , Thao Thanh Nguyen  3 , Cong Van Cung  4 , Hoa Binh Nguyen  4 , Nhung Viet Nguyen  4 , Van Van Nguyen  5 , Ngan Thi Tran  2 , Giang Hoai Nguyen  2 , Zhi Zhen Qin  6 , Jacob Creswell  6
Affiliations

Early Evaluation of an Ultra-Portable X-ray System for Tuberculosis Active Case Finding

Luan Nguyen Quang Vo et al. Trop Med Infect Dis. .

Abstract

X-ray screening is an important tool in tuberculosis (TB) prevention and care, but access has historically been restricted by its immobile nature. As recent advancements have improved the portability of modern X-ray systems, this study represents an early evaluation of the safety, image quality and yield of using an ultra-portable X-ray system for active case finding (ACF). We reported operational and radiological performance characteristics and compared image quality between the ultra-portable and two reference systems. Image quality was rated by three human readers and by an artificial intelligence (AI) software. We deployed the ultra-portable X-ray alongside the reference system for community-based ACF and described TB care cascades for each system. The ultra-portable system operated within advertised specifications and radiologic tolerances, except on X-ray capture capacity, which was 58% lower than the reported maximum of 100 exposures per charge. The mean image quality rating from radiologists for the ultra-portable system was significantly lower than the reference (3.71 vs. 3.99, p < 0.001). However, we detected no significant differences in TB abnormality scores using the AI software (p = 0.571), nor in any of the steps along the TB care cascade during our ACF campaign. Despite some shortcomings, ultra-portable X-ray systems have significant potential to improve case detection and equitable access to high-quality TB care.

Keywords: X-ray; active case finding; handheld; tuberculosis; ultra-portable; vulnerable populations.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Illustration of study timeline, interventions and activities.
Figure 2
Figure 2
TB care cascade disaggregated by X-ray system used during the community screening events.
See this image and copyright information in PMC

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