Uganda recorded 96,000 TB cases in 2023, with a continued upward trend in diagnoses and a concerning rise in TB-related deaths. Co-infection with HIV remains a serious challenge, as over one-third of people diagnosed with TB were also living with HIV. Missed TB cases, both drug-sensitive and drug-resistant, reflect the need for continued investment in screening infrastructure.
Keeping this in mind, the National Tuberculosis and Leprosy Programme (NTLP) focused on the use of portable digital X-rays with AI software for TB screening. They can help provide diagnostic facilities, not only in high-TB burden districts but also for community outreach.
Our work in Uganda began in 2018, when the IDA Foundation procured 5 Delft Light portable X-ray systems with CAD4TB. In 2020, DAHW provided 2 additional Delft Light systems with CAD4TB to the Uganda Catholic Medical Bureau. That same year, Lubaya Hospital implemented CAD4TB through Protid Africa.
Witnessing the impact, in 2021, 10 more Delft Light systems with CAD4TB were deployed. Five were procured under the introducing New Tools Project (iNTP) by the StopTB Partnership, the other five were provided through the Partnership for Supply Chain Management (PFSCM).
Also in 2021, the National TB and Leprosy Programme acquired 2 Delft OneStopTB X-ray Trucks through the UNOPS, each clinic outfitted with an EasyDR multi-functional X-ray and the CAD4TB, followed by three more Delft OneStopTB X-ray clinics later in the year.
In 2024, 7 Delft Light systems, each equipped with CAD4TB, were delivered to Joint Medical Stores.
The most significant scale-up came in 2025. The Ministry of Health received 11 Delft OneStopTB X-ray Trucks, each equipped with EasyDR and CAD4TB. That same year, 19 Delft Light systems with CAD4TB were delivered to the National TB & Leprosy Division, while Joint Medical Stores received 22 Delft Light and CAD4TB more. Separately, 42 additional Delft Light units were supplied to the Ministry of Health through PFSCM.
Making a Difference
Research paper
Delft Imaging, in collaboration with its in-country partner, supports all these installations and services through long-term service contracts. Additionally, we are proudly supporting the Infectious Disease Institute of Makerere University (IDI). Since late 2021, IDI, with the help of the StopTB Partnership’s TB REACH program, has been utilising CAD4TB to investigate the performance of A.I in the rural towns of Uganda.
The CAD4TB installed in the tertiary hospitals of Gulu, Lira and Kitgum served a combined population of more than one million. Each person with presumed TB in the hospital received a digital chest X-ray that is read by CAD4TB, trained human readers and a highly sensitive molecular diagnostic test (Xpert). These outcomes were recorded and compared to that of the molecular test in order to analyse its accuracy and optimal settings. To read more about the project, please see their case study.
In the words of Michael Odit, a Project Radiographer at IDI, “AI has helped us a lot. If you have many patients, you only need to send the images to the AI box. You can work on many patients in the shortest possible time.”
Over the years, various partners have published about the impact of different X-ray systems and CAD solutions for TB screening efforts.
The Delft Light portable backpack X-rays with CAD4TB were used for the TB screenings at health facilities in high TB burden districts and for community outreach. Between June 2020 and May 2021, more than a thousand individuals were X-rayed in health facility settings. Of those screened, 21% HAD ABNORMAL X-ray, 86% were tested by GeneXpert and the remaining 35% were confirmed with TB. In community settings in March 2021, more than 1400 individuals were X-rayed. Of whom, 13.5% had abnormal X-rays and were tested by GeneXpert. About 6.3% were confirmed with TB.
It was concluded that TB screening by mobile digital X-ray in health facilities had a higher yield of TB when used at health facilities as opposed to community settings, particularly among PLHIV and TB contact. Thus, to improve early case detection, the national TB programs and partners were recommended to scale up the usage of digital X-ray systems with CAD4TB in the screenings of high-risk populations. In the 2022 Union World Conference on Lung Health, the stakeholders in Uganda highlighted the use of dCXR and CAD4TB for systematic TB screening among PLHIV. They concluded that this approach led to twice as high TB yield among PLHIV and contacts.
A case study, presented in the 8th Webinar of the StopTB Partnerships’ Focus Group on AI-based Imaging for TB, showed that Uganda uses about 700,000 Xpert tests annually. Digital chest X-rays with CAD4TB can significantly reduce the number of Xpert tests needed, with minimal reduction of diagnosed TB cases.
Stop TB Partnership, in 2024, released a report on the impact of Delft Light and CAD4TB in Uganda. NTLP, together with USAID and Stop TB partnership, rolled out five Delft Light, in combination with CAD4TB software, through the introducing New Tools Project (iNTP). This adds to the existing seven digital X-ray systems with CAD in the country, and fits into strategies to close the detection gap in Uganda. According to the report, these innovative tools have notably improved diagnostic capabilities, with over 5,500 individuals screened and 591 diagnosed with TB. The integration of these technologies has significantly reduced screening and diagnosis times, facilitating easier access to TB screening and marking significant progress in Uganda’s fight against TB.
Webinar insights
For more information about how CAD4TB is used and validated in Uganda, please refer to the story of ‘Computer Aided Detection of Tuberculosis Using Chest Radiography: A Clinical Validation of the CAD4TB Version 7 System,’ presented by Dr. Stela Zawedde-Muyanja, Research Scientist at the Infectious Diseases Institute, part of the College of Health Sciences of Makerere University in Uganda. The story was presented during the 2023 Delft webinar. During the webinar, Dr. Zawedde-Muyanja noted “Optimizing the CAD4TB threshold scores for TB screening in health facility settings could enable healthcare workers to detect an optimum number of TB cases while significantly reducing the number of Xpert tests needed.”
For more information about how the Delft Light portable X-ray and CAD4TB solutions are used in Uganda, please view the story of ‘Expanding Access to New Tools for TB Screening and Diagnosis,’ presented by Dr. Turyahabwe Stavia, Assistant Commissioner at the NTLP in Uganda. The story was presented during the Delft webinar of 2022. The use case of the Delft Light portable X-ray and CAD4TB being used in Uganda was further presented in the story of ‘Use of Mobile Digital X-ray with CAD4TB at Health Facility & Community Setting,’ presented by Dr. Aldomoro Burua of the NTLP in Uganda during the 2021 Delft webinar.
For more information on how the Uganda Catholic Medical Bureau (UCMB) in Uganda uses the Delft Light portable X-ray system and CAD4TB, please view the story on ‘Field Experience of Community Digital X-ray Screening Using Delft Light in West Nile Region of Uganda,’ presented by Dr. Mbusa Kabagambe Patrick, program manager at UCMB. The story was presented during the Delft webinar of 2022. You can watch all these webinars on our YouTube channel.
In February 2024, the Stop TB Partnership released a report detailing how Uganda’s Makerere University Joint AIDS Program (MJAP) uses LabXpert for integrated connectivity with CAD4TB software and molecular diagnostics for TB detection. Learn more about Uganda’s use of data connectivity to strengthen its healthcare system on the Delft Webinar.
Case studies
2021
Health Facility & Community Screening: TB screening in high-burden districts and hotspots through health facilities and community outreach revealed crucial findings, with a higher yield at health facilities, particularly among people living with HIV and TB contacts. Discover the impact of mobile digital X-ray screenings in identifying TB cases across different settings.
2022
Community level screening with OneStopTB Mobile Clinic: Targeted TB screening in high-risk areas, using X-rays and confirmatory tests, reached over 11,000 people, diagnosing 249 TB cases with a majority starting treatment promptly. This strategy highlights the effectiveness of mobile clinics in detecting and initiating treatment for TB in communities, emphasizing the importance of same-day diagnosis and treatment.
TB screening among PLHIV with Delft Light & CAD4TB: In Uganda, TB screening using digital X-rays and CAD among people living with HIV led to significant TB detection, especially within the HIV-positive population. This approach underscores the importance of prioritizing such screenings for early TB diagnosis and treatment, particularly among vulnerable groups for enhanced health outcomes.
2024
During the Union 2024, Uganda’s National TB and Leprosy Program reported the successful implementation of twelve Delft Light digital X-ray systems with CAD4TB in both community and health facility settings. Health workers were trained to use the technology alongside a standardized screening algorithm, with individuals showing abnormalities undergoing GeneXpert testing. The study found that a CAD4TB threshold score of 50 or higher significantly improved TB diagnostic yield and could help conserve testing resources. It also recommended using a lower threshold for people living with HIV to further enhance case detection.
Press coverage
The utilization of the OneStopTB mobile clinics, EasyDR X-ray systems and the CAD4TB software amongst a pilgrim population in Uganda has also been covered by the new channel NewVision in Uganda.
A recent article in Gavi dives into how Uganda is deploying these solutions to bring TB screening to remote areas, thereby overcoming healthcare barriers and benefiting underserved communities.
In 2024, Monitor reported on Uganda’s tuberculosis mobile screening campaign, which features 17 Delft Light systems and five mobile clinics to improve TB detection and treatment access, boosting public health outcomes in vulnerable communities.
In 2025, Kitgum General Hospital in Uganda received a major boost in its diagnostic capabilities with the deployment of the Delft Light with CAD4TB software. After nearly two years without a functioning X-ray machine, the hospital can now resume TB screening and diagnosis, especially in hard-to-reach, resource-limited settings. Dr. Geoffrey Okello, the hospital’s Medical Superintendent, highlighted the expected impact on care delivery and patient outcomes. The initiative aligns with Uganda’s efforts to expand equitable access to essential health services. Read more via The Independent.
Same year (2025), reported by The Kampala Post, Uganda expanded its national TB response with the deployment of tuk-tuk–mounted mobile units equipped with Delft Light portable X-ray systems and CAD4TB software. Delivered to the Ministry of Health with support from USAID and the U.S. Government, the new fleet includes 48 portable X-ray machines, 33 TB-LAMP platforms, and 33 Mobile XLAMP tricycles – reaching 68 districts and aiming to screen over 500,000 people in remote areas. This marks a continuation of Uganda’s leadership in using AI-powered mobile diagnostics to close detection gaps and move closer to TB elimination.
