Tuberculosis remains a major health challenge in Pakistan, globally among fifth among the TB high burden countries. According to the latest WHO report, Pakistan has 600,000 TB cases each year. Mercy Corps and the National TB Control Program have identified 470,000 of these cases, leaving many unreported. These missed cases are often patients unaware of TB services or those in areas with limited access to healthcare.

To reach these underserved patients, portable backpack X-ray units, Delft Light, and the AI-enabled CAD4TB are being deployed nationwide. By directly bringing TB screening to people living in underserved regions, the aim is to reduce TB transmission and decrease the morbidity and mortality associated with the disease. In the recent Delft webinar, Dr Adeel Tahir, Director of the TB Program at Mercy Corps Pakistan, and our local country partner, Mr Sohail Siddiqui, the Country Head of OmniTech, shared their experience in deployment, as well as the impact of the solutions in the field.

Mercy Corps and the Fight Against TB

Mercy Corps has been tirelessly working in over 40 countries and has been at the forefront of TB control initiatives in Pakistan since 1986. Dr Adeel Tahir explains, “Mercy Corps has been the principal recipient of Global Funds since 2007, continuously working in TB control initiatives for over a decade.” Their focus on both active and passive care services has been crucial in reaching patients in far-flung regions, away from main health facilities.

Delft Imaging has had a long-standing relationship with Pakistan since 2013. With over 200 solutions in use across the nation today, they are actively adopting innovative solutions to ensure effective TB screening, enabling timely intervention for treatment.

One of the critical interventions by Mercy Corps involves the use of 40 mobile vans equipped with digital X-ray machines integrated with CAD4TB software and GeneXpert. These mobile units enable on-the-spot TB screening and diagnosis, significantly improving the detection rate. “The best thing that CAD4TB has done is that the accuracy of diagnosis has increased. When we use the score generated by CAD4TB, our physicians are quite comfortable and confident in ordering the sputum sample for these patients,” says Dr. Tahir.

However, 2023 was a milestone year, with NTP and Mercy Corps commissioning 57 Delft MAC and 35 Delft Light Portable (backpack) X-ray systems. Pakistan ordered more than 80 mobile and portable X-ray systems. Each of these systems was combined and procured with CAD4TB software.

Challenges and Innovations in Deployment

Each deployment comes with its pains and gains. Sohail Siddiqui spoke about the obstacles he and his team encountered during the implementation, including infrastructure issues, transportation difficulties, and language barriers.

“In countries like Pakistan, there are a lot of challenges, especially in remote areas where there is no light, water, or basic necessities,” says Siddiqui. The training process for local healthcare workers also presented significant challenges. Siddiqui notes, “Giving them a three-day training to introduce the product and how it works was just the beginning. Continuous support and training were necessary to ensure effective usage.”

Despite these hurdles, the collaborative efforts between Delft Imaging and Mercy Corps have resulted in successful installations and operations. “We have selected five districts, and we are going to give them five centralized training sessions in these areas. And all the participants, like, you know, minimum, you know, 20 participants, are available for this training. And it’s like, more than a hundred people will be trained at the end of this year,” Siddiqui adds.

NTP and Mercy Corps are working together to ensure smooth training and installation. “Yes, I have met with Mercy Corps and NTP a number of times. Both are very supportive. They are working hard, and they’re very helpful, and the team is very efficient. So, we have good communication between these two and are working very well in this region to implement these 79 machines,” Siddiqui concluded.

Impact and Future Ahead

The impact of deploying Delft Light and CAD4TB in Pakistan has been profound. According to Dr. Tahir, the mobile units have screened thousands of individuals, identifying many TB cases that might have otherwise gone undiagnosed. “In the last month, we conducted almost 600 chest scans through these 40 mobile vans, identifying around 1500 TB patients.”

Looking ahead, the deployment of 79 Delft Light systems and the ongoing training of healthcare professionals in their use promise to further expand the reach and effectiveness of TB detection efforts. “We are planning to train technicians through the support of Delft Imaging and OmniTech, ensuring that these machines are utilised efficiently in high-burden districts,” says Dr Tahir.

Integrating Delft Light and CAD4TB into Pakistan’s healthcare infrastructure significantly advances the fight against TB. The commitment and collaboration of organizations like Mercy Corps and OmniTech are crucial in overcoming the challenges and ensuring that these life-saving technologies reach those who need them most. As both Siddiqui and Dr. Tahir emphasize, the ultimate goal is to reduce TB transmission, morbidity, and mortality, paving the way for a healthier future for all Pakistanis.