Submission ID 131603
| Issue/Objective | Scaling chest X-ray screening for Tuberculosis in high-burden settings is often constrained by limited radiology capacity and fragmented diagnostic systems. The diagnostic delays that undermine TB outcomes in Nigeria are well understood: delays between ordering an X-ray and receiving a reading; delays in treatment initiation caused by the challenge of interpreting complex chest X-rays at the point of care; and delays in longitudinal monitoring of patient progress. Each of these delays extends illness, accelerates transmission, and erodes programme outcomes. |
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| Methodology/Approach | Instant Health Services' Teleradiology platform XMAP was deployed to support centralized interpretation of chest X-ray images from TB screening activities across multiple facilities and mobile diagnostic sites in Nigeria. CAD4TB scoring was integrated to support triage and image prioritization. Images were uploaded to a secure cloud-based system for remote review, interpretation and reporting by trained radiologists. Screening outcomes and operational indicators were assessed using programmatic data collected between January and December 2025. |
| Results | During the study period, 115,176 CXRs were uploaded and interpreted through the platform. Radiologists identified 29,308 (25.4%) images suggestive of TB requiring further diagnostic evaluation. CAD4TB triage identified 81.6% of images as potentially abnormal, while 18% had scores ≤40, suggesting triage opportunities for lower-priority review. The centralized teleradiology system enabled rapid interpretation of radiographs from geographically dispersed screening sites and facilitated efficient referral for confirmatory testing. |
| Discussion/Conclusion | The XMAP platform demonstrates the operational feasibility of integrating teleradiology and artificial intelligence to support large-scale TB screening programs. Digital radiology networks can significantly expand access to expert interpretation, improve efficiency in radiologist workload allocation, and strengthen TB diagnostic pathways in high-burden settings. |
| Presenters and Affiliations | Kehinde Jimoh Agbaiyero Instant Health Services Adetayo James Instant Health Services Clement Adesigbin National TB and Leprosy Control Program Emperor Ubochioma National TB and Leprosy Control Program Kehinde Jimoh Agbaiyero Instant Health Services |
