Location: Timor-Leste // Organization: Delft Imaging

Introduction

A national TB prevalence survey was conducted from 2020 to 2023 to determine the burden of TB, including subclinical TB cases.

Intervention
  • In this nationally representative random cluster survey, participants aged 15 and older underwent symptom screening (cough >2 weeks, fever, weight loss, or night sweats) and Chest X-rays (CXRs) using Delft Light ultra-portable X-rays with CAD4TB (threshold ≥60).
  • Participants with abnormal CXRs and/or any TB symptoms underwent two GeneXpert tests, and liquid culture was performed on those who tested Xpert positive.
Result
  • Out of 15,267 participants, 7.4% (1,125) were symptom screen positive, and 4.4% (675) were CXR/CAD4TB screen positive.
  • Among those with high CAD4TB scores, 36% had no TB symptoms. This resulted in 22% of bacteriologically confirmed TB cases being subclinical.
  • A total of 162 participants were confirmed with Bac+ TB. Notably, 22% of Bac+ TB cases would have been missed without using Chest X-rays with CAD4TB.
Conclusion
  • The survey revealed a substantial burden of subclinical TB in Timor-Leste.
  • These findings underscore the importance of active case finding and the use of CXRs to enhance the sensitivity of TB screening algorithms.

REFERENCE: Atok, l. et al (2024, November 12-16). Sub-clinical TB in participants of a national prevalence survey in Timor-Leste [Presentation]. The Union World Conference on Lung Health, Bali, Indonesia.