WHO recommends CAD with chest x-rays to fight tuberculosis

The World Health Organization (WHO) has updated its recommendations for tuberculosis (TB) screening to now include the use of computer-aided detection (CAD) applications in chest radiography, according to officials who discussed the update during a presentation on March 23 organized by the International Society of Radiology.

The new recommendation comes at a time when screening programs around the world are falling short of goals set for early detection and treatment of TB by the United Nations in 2018. Globally, 7.1 million people were diagnosed and treated for TB in 2019 out of an estimated 10 million cases. About 29% of all people with TB were not diagnosed or reported to WHO, according to Cecily Miller, PhD, an epidemiologist and biostatistician with the WHO’s global TB program.

She noted that the COVID-19 pandemic has made matters much worse. In 2019, approximately 1.4 million fewer people worldwide received care for TB than in 2020.

TB screening with the assistance of CAD applications should be done systematically in a selected population to distinguish people with a higher probability of TB and should be followed with a diagnostic evaluation using a test with high accuracy to confirm a diagnosis, Miller said.

“This is a very significant addition to our recommendations for screening. This comes after many years of discussions at WHO and finally having the appropriate data to evaluate the performance of CAD,” Miller said.

The International Society of Radiology organized the presentation in collaboration with the WHO to mark World TB Day on March 24. The theme of World TB Day this year is “The Clock is Ticking,” and it is meant to remind global leaders that efforts to end TB must be kept up, in spite of challenges introduced by the novel coronavirus disease.

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