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Chest radiography in TB

By Madhukar Pai Moderator | 14 Feb, 2017

In December 2016, WHO released a very useful, consolidated summary of WHO recommendations on the use chest radiography (CXR) in TB detection and guidance on programmatic approaches to use CXR within primary care services.

WHO underscores the importance of CXR an essential tool for the early detection of TB, and therefore fundamental to achieve the targets set out in WHO’s End TB Strategy. The report provides guidance in the following areas:

 Chest radiography as a triage tool.

 Chest radiography as a diagnostic aid.

 Chest radiography as a screening tool.

 Technical specification, quality assurance and safety.

 Strategic planning for use of CXR in national TB control.

The WHO report has also summarized the key research questions, including the role of computer-aided diagnosis (CAD) for CXR interpretation.

Report is available at: http://apps.who.int/iris/bitstream/10665/252424/1/9789241511506-eng.pdf

As we all know, the utility of radiology goes well beyond TB, and this technology should be seen as an 'essential diagnostic' for primary healthcare.

The reality, however, is that x-rays are rarely available at the lower tiers of the healthcare delivery system. Please see this 14 country survey by Sophie Huddart & Emily MacLean: http://thelancet.com/journals/langlo/article/PIIS2214-109X(16)30248-0/fulltext

Most countries have chest radiology available only at the L2 (district) or L3 level (tertiary/reference) levels.

I would love to hear about availability of chest x-rays in your countries. How accessible is it, at what level, cost, and whether digital systems are available?




edgar franchi Replied at 9:13 PM, 14 Feb 2017

In my country, Venezuela right now the cases of TB are increasing because of the humanitarian crisis we are facing in the last year.. I work in a 300 hundred beds hospital..however frequently there are problems regarding the use of cxr..the causes...lack of material to obtain the cxr..equipments that are obsolete and are not replaced by new ones...in summary the root of all these is lack of money to mantain or repair the old equipments...our laws theoretically offer free health care..but in the practice unfortunately this is not accomplished.

RAJESH SOOD Replied at 12:32 PM, 26 Feb 2017

Try a public private partnership mode. The CT Scan, Dialysis in Public Hospitals in PPP mode have been quite success out here.

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