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?