Our projects in lung health
Ghana recorded an estimated 44,000 new tuberculosis cases in 2023 while nearly 25,000 individuals remained undiagnosed. At the same time, around 12,000 people died from TB, marking an 11 % decline compared to 2022. The number of people living with both TB and HIV stood at 4,800, a notable 27 % decrease. Ghana’s diagnostic and outreach infrastructure continues to play a vital role in turning the tide against TB.
We are proud to support Ghana’s TB response for over a decade through sustained engagement and partnerships. In 2014, we delivered the first containerized X-ray unit equipped with an EasyDR multi-functional X-ray system and our CAD4TB software to support the upcoming national TB prevalence survey. The following year, four additional portable X-ray systems (Atomed) were added, enabling the team to complete the national survey in just six months—screening almost 60,000 people.
In 2016, we were awarded the ‘Accelerating TB Case Detection’ project, financed by the Dutch Enterprise Agency (now Invest International). This bilateral effort between the Dutch and Ghanaian governments aimed to strengthen Ghana’s TB detection infrastructure by installing 52 EasyDR stationary X-ray systems across the country. All systems were delivered with CAD4TB software to support automated detection of TB-related abnormalities on chest X-rays. Of the 52 units, 30 were placed in containerized clinics, 20 in existing health facilities, and 2 in Delft OneStopTB X-ray Trucks. The project also included installation, onsite training, and a radiographer training program to ensure sustainable impact.
As of 2022, more than 1.4 million X-rays had been performed using these systems. Each year, Delft Imaging conducts Planned Preventive Maintenance (PPM) visits to keep systems operating optimally. Between 2020 and 2022, each system averaged fewer than 0.59 calls per year for technical issues and 1.22 calls per year for IT/application-related issues. Technical issues were typically resolved in under two days and IT/application issues in under one. User satisfaction averaged 95% over four years, and 96% of users reported that the PPM visits were helpful.
In addition to this flagship project, Delft Imaging has supported numerous public and private institutions across Ghana. In 2017, three containerized clinics equipped with EasyDR and CAD4TB were delivered to the National TB Programme. In 2021, two more EasyDR systems were supplied to St. Elizabeth Hospital and St. Mary Hospital.
In 2022, Delft Imaging delivered three Delft Light portable backpack X-ray systems with CAD4TB to the Ministry of Health, followed by another 20 Delft Light systems and 20 CAD4TB licenses later that year, funded through COVID-19 resources.
To support its operations in Ghana and beyond, Delft Imaging established its local subsidiary, Delft Imaging Ghana. The local team—comprising engineers, IT and application specialists, and radiographers—provides direct support for installations and services throughout Ghana and across Africa. Today, Ghana’s installed base includes nearly 60 EasyDR systems, two mobile X-ray units, 20 Delft Light systems, and over 85 CAD4TB installations nationwide.
Our projects in maternal health
Ghana reported a maternal mortality ratio of 234 deaths per 100,000 live births in 2023, continuing a gradual decline from over 900 in 2000. While national programs have expanded antenatal care coverage and diagnostic capabilities, particularly in primary healthcare units, remain constrained. Improving early risk identification is key to achieving further reductions in maternal deaths.
In 2020, BabyChecker was introduced in Ghana as part of an initiative to refine its artificial intelligence further and evaluate real-world user performance. This deployment focused on collecting data from health workers and exploring training approaches tailored to local contexts. The insights gained helped improve both the mobile application and the support model for implementation.
In 2023, Delft Imaging partnered with the TREATS Association to facilitate this early-stage deployment. Ghana is among the first countries where BabyChecker was field-tested to assess usability and data quality at the primary healthcare level. The collaboration strengthened the foundation for subsequent software versions and helped define best practices for adoption in similar settings.
Making a Difference
Webinar insights
For more information about the roll-out of the 52 EasyDR stationary X-ray systems across Ghana, please view the story of ‘Accelerating Case Detection of Tuberculosis in Ghana: A Health System Strengthening Project with a Focus on TB,’ presented by Dr. Nicholas Adjabu, Deputy Director of the Clinical Engineering Department at Ghana Health Service. The story was presented during the 2022 Delft Imaging webinar. The same project was also covered by the news station BBC World News, and the coverage of the of the project can be viewed here. The story was also covered on the news website Ghana Web.
During the 2024 webinar “Innovation in Action: Accelerating TB Screening in Low-Resource Settings with Digital X-rays and CAD,” Dr. Yaw Adusi-Poku, National TB Control Programme Manager for the Ghana Health Service, shared insights on the country’s innovative TB screening strategy. Ghana pioneered the use of digital X-ray systems with CAD4TB, which significantly improved detection, especially among people living with HIV. A pilot study screening 2,639 individuals achieved a TB yield of 2 percent, with 26 percent of cases being asymptomatic and detected solely through X-ray. Dr. Adusi-Poku emphasized, “The TB yield was 2% and those asymptomatic just using X-ray alone was 26%.” Building on this success, Ghana scaled up TB preventive therapy nationwide in 2020 and now focuses on hotspot screening in 2024, targeting prisons, mining communities, and urban slums to close detection gaps.
Case studies
In Ghana’s rural mining communities, an integrated mobile clinic approach was used to screen and diagnose TB, HIV, and COVID-19, reaching thousands and identifying numerous cases. Discover how this efficient strategy helps tackle these diseases by providing critical diagnostics and care in high-risk areas through this case study “Integrated Case-finding approach for TB, HIV & COVID-19 in Mining Communities with OneStopTB Mobile Clinic.”
Press coverage
The Global Fund also wrote about utilization of the CAD4TB software, using Ghana as an example, in their article ‘Tools to Turbocharge the Fight Against Tuberculosis.’ They wrote: Artificial Intelligence (AI) has the potential to revolutionize the way X-rays are read. Many computer-aided detection tools rely on AI to rapidly and accurately read X-rays to find TB. In addition to screening for TB, a recent study found that AI could save on costs by rapidly reading X-rays to determine if further and costly testing was needed. AI has the potential to be a game-changer in the fight against TB.
The Minister of Foreign Affairs and Regional Integration, Shirley Ayorkor Botchwey, thanked the Dutch government for its strong support of Ghana’s health sector, mentioning the ORIO project, where we installed 52 portable X-ray systems, equipped with CAD4TB, across Ghana. Read about it here.
