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Diagnostic accuracy of three computer-aided detection systems for detecting pulmonary tuberculosis on chest radiography when used for screening: analysis of an international, multicenter migrants screening study

The aim of this study was to independently evaluate the diagnostic accuracy of three artificial intelligence (AI)-based computer aided detection (CAD) systems for detecting pulmonary tuberculosis (TB) on global migrants screening chest x-ray (CXR) cases.

Retrospective clinical data and CXR images were collected from the International Organization for Migration (IOM) pre-migration health assessment TB screening global database for US-bound migrants. A total of 2,812 participants were…

Diagnostic accuracy of chest X-ray interpretation for tuberculosis by three artificial intelligence-based software in a screening use-case: an individual patient meta-analysis of global data

Abstract

Background
Chest X-ray (CXR) screening is a useful diagnostic tool to test individuals at high risk of tuberculosis (TB), yet image interpretation requires trained human readers who are in short supply in many high TB burden countries. Therefore, CXR interpretation by computer-aided detection software (CAD) may overcome some of these challenges, but evidence of its accuracy is still limited.

We established a CXR library with images and metadata from…

A new resource on artificial intelligence powered computer automated detection software products for tuberculosis programmes and implementers

Abstract

Recently, the number of artificial intelligence-powered computer-aided detection (CAD) products that detect tuberculosis (TB)-related abnormalities from chest X-rays (CXR) available on the market has increased. Although CXR is a relatively effective and inexpensive method for TB screening and triaging, a shortage of skilled radiologists in many high TB-burden countries limits its use. CAD technology offers a solution to this problem. Before adopting a CAD product,…

Pre-migration TB screening-the first step is always the hardest

Abstract

As the proportion of foreign-born persons among TB notifications continues to rise, Japan is preparing to introduce pre-migration TB screening for those coming from selected countries, who are intending to stay for more than 90 days. It has announced that the programme will commence in 2020. In this review, the authors examine the experiences from two countries which already have years of experience in operating pre-migration TB screening, namely the United Kingdom…

Tools to implement the WHO End TB Strategy: Addressing common challenges in high and low endemic countries

Aim
The purpose of this viewpoint is to summarize the advantages and constraints of the tools and strategies available for reducing the annual incidence of TB by implementing the WHO End TB Strategy and the linked WHO TB Elimination Framework with special reference to Oman.

Methods
The case-study was built based on the presentations and discussions at an international workshop on TB elimination in low incidence countries organized by the Ministry of…

New Xpert MTB/XDR: added value and future in the field

The spread of DR-TB strains threatens recent gains in global TB control, with evidence that the majority of patients with rifampicin-resistant (RR-TB) or multi-drug resistant (MDR-TB) TB acquire their infection through person-to-person transmission. Inadequate diagnostic and treatment options have hampered an effective global response. The use of Xpert MTB/RIF as a rapid and sensitive frontline TB detection test has been shown to improve patient outcomes and is cost-effective, but data for…

Tuberculosis in migrants - screening, surveillance and ethics

Tuberculosis (TB) is the leading infectious cause of human mortality and is responsible for nearly 2 million deaths every year. It is often regarded as a ‘silent killer’ because it predominantly affects the poor and marginalized, and disease outbreaks occur in ‘slow motion’ compared to Ebola or coronavirus 2 (COVID-19). In low incidence countries, TB is predominantly an imported disease and TB control in migrants is pivotal for countries to progress towards TB elimination in accordance with…

Health profile of adult special immigrant visa holders arriving from Iraq and Afghanistan to the United States, 2009–2017: A cross-sectional analysis

Abstract

Background
Between 2,000 and 19,000 Special Immigrant Visa (SIV) holders (SIVH) from Iraq and Afghanistan resettle in the United States annually. Despite the increase in SIV admissions to the US over recent years, little is known about the health conditions in SIV populations. We assessed the burden of select communicable and noncommunicable diseases (NCDs) in SIV adults to guide recommendations to clinicians in the US.

Methods and…

Effectiveness of pre-entry active tuberculosis and post-entry latent tuberculosis screening in new entrants to the UK: a retrospective, population-based cohort study

Abstract

BACKGROUND: Evaluating interventions that might lead to a reduction in tuberculosis in high-income countries with a low incidence of the disease is key to accelerate progress towards its elimination. In such countries, migrants are known to contribute a large proportion of tuberculosis cases to the burden. We assessed the effectiveness of screening for active tuberculosis before entry to the UK and for latent tuberculosis infection (LTBI) post-entry for reduction of…

Prevalence of Tuberculosis Disease Among Adult US-Bound Refugees with Chronic Kidney Disease

The association between chronic kidney disease (CKD) and tuberculosis disease (TB) has been recognized for decades. Recently CKD prevalence is increasing in low- to middle-income countries with high TB burden. Using data from the required overseas medical exam and the recommended US follow-up exam for 444,356 US-bound refugees aged ≥ 18 during 2009–2017, we ran Poisson regression to assess the prevalence of TB among refugees with and without CKD, controlling for sex, age,…