Our projects in lung health
Across Malawi, tuberculosis remains a persistent public health issue. In 2023, 31,000 people were estimated to have developed TB, and over 3,100 lost their lives to the disease. Co-infection with HIV remains a factor in TB control, with 3,400 people affected by both. While Malawi has made progress in diagnosis and care, drug-resistant TB, approaching 700 cases in 2023, continues to challenge treatment efforts.
Most of the nation resides in rural areas, where Delft OneStopTB X-ray Clinics have been particularly helpful. In 2016, Delft Imaging provided 7 Delft OneStopTB X-ray Clinics to the country, fitted with EasyDR systems. The nation was classified into seven regions, with each area assigned its mobile clinics. These mobile clinic still functions today, with maintenance services provided every year.
In the same year, we supplied 2 ultra-portable X-ray systems and CAD4TB to the KNCV in Malawi. The solutions supported TB active case-finding activities under the Challenge TB project in Malawi.
Across 2017, 2018, and 2019, numerous sites received the CAD4TB, including the Ministry of Health (National Tuberculosis Program), Philips, and the Liverpool School of Tropical Medicine.
In 2022, we delivered a range of diagnostic solutions to support TB control efforts in Malawi. A Delft Light X-ray system was deployed through the National Tuberculosis Program, along with 10 CAD4TB systems and an additional Delft Light for Malawi’s Centre for Disease Control. Later that same year, we supplied 15 Delft MAC mobile X-ray units and CAD4TB to the Ministry of Health to further expand screening reach.
In 2023, Madisi Mission Hospital received another Delft MAC system with CAD4TB to support its TB services. Most recently, in 2024, we delivered 2 Delft Light systems, each paired with CAD4TB, to Central Medical Stores to strengthen diagnostic capacity at the national level.
Our projects in maternal health
In Malawi, maternal mortality decreased to 225 deaths per 100,000 live births in 2023, down from 1,115 in 2000. This progress reflects broader improvements in healthcare delivery, but is still challenged by limited diagnostic infrastructure in rural areas. Strengthening maternal health services through early detection and community-level interventions remains a national priority.
BabyChecker is currently used at St. Gabriel Mission Hospital and Madisi Mission Hospital.
These efforts reflect Malawi’s commitment to improving antenatal care accessibility and risk detection in underserved areas.
Making a difference
Research paper
Over the years, different stakeholders in Malawi have published about utilizing the OneStopTB clinics and the CAD4TB software. Their scientific efforts showed that digital CXR using CAD4TB with universal HIV screening significantly increased timelines and completeness of HIV and TB diagnosis.
The CASTLE study in Malawi used CAD4TB to enhance TB diagnosis in adults with HIV through computer-aided chest X-rays and urine LAM tests. This cluster randomized trial demonstrated improved diagnostic accuracy for TB in hospitalized patients. Read the full study here.
Webinar insights
For more information about how the OneStopTB mobile clinics are used in Malawi, please view the story ‘Targeted Active TB Case Finding Using Mobile TB Diagnostics Units in Malawi, presented by Dr. Isaias Dambe of the National TB and Leprosy Elimination Program in Malawi. The story was presented during the Delft Imaging webinar of 2022. During the webinar, Dr. Dambe noted: “Malawians have poor health-seeking behavior. About 36% of those sick don’t go to the hospital. Another 50% go to the hospital, but the health system can’t help them. Therefore, we realized that there is a need for active TB case-finding. We approached the WHO, and they recommended the Global Fund, which assisted us in procuring mobile X-ray diagnostic clinics for communities, especially the vulnerable. We procured seven mobile X-ray clinics from Delft Imaging to cover our nation.”
TB has been extensively used in Malawi, please view the story of ‘Computer-Aided X-ray Screening for Tuberculosis and HIV Testing: A Randomised Trial and Cost-Effectiveness Analysis in Malawi’, as presented by Dr. Peter MacPherson. The story was presented during the 2022 Delft Imaging webinar.
Case studies
Find missing cases of TB in high-risk populations with OneStopTB Clinic in 2021: During a mass TB screening at a busy bus terminal, over 2,000 people were screened, uncovering 22 confirmed TB cases. This demonstrates how systematic screening with the OneStopTB Mobile Clinic can enhance TB case detection
Active TB Case-finding with OneStopTB Clinic in 2022: Discover how this OneStopTB Mobile Clinic is vital in identifying and treating TB effectively, emphasizing the need for expanded resources in active TB case finding.
Improving TB Case-finding in Key Populations with OneStopTB Clinic in 2023: The NTLEP’s mobile outreach for TB screening in 28 districts utilized digital X-ray, CAD4TB, and GeneXpert, revealing a high TB incidence among various high-risk groups. Learn about the significant findings from this approach, which underscores the necessity for targeted screening strategies and the effectiveness of combining X-ray and symptom screening in TB detection.
TB Services to mining and construction workers through Mobile Clinics in 2024: Malawi’s National TB Program partnered with mining and construction companies to screen workers using Delft’s Mobile Clinics equipped with EasyDR, CAD4TB, and GeneXpert. Of 5,461 people screened, 51 active TB cases were detected, highlighting the urgent need for regular screening among high-risk occupational groups.
High TB cases yield with W4SS and X-ray & CAD in 2024: Since 2018, Malawi has deployed Delft Imaging’s Mobile Clinics with digital X-ray, CAD4TB, and GeneXpert for urban TB screening, increasing case detection by 4.4 times compared to symptom screening alone. In 2023, this approach diagnosed 1,164 TB cases – 6% of all national notifications – highlighting its critical role in scaling active case-finding efforts.
