US CDC supports expansion of AI-enabled X-ray machines to tackle Nigeria's TB-HIV burden

The US Centre for Disease Control and Prevention (US-CDC) has reaffirmed its commitment to supporting Nigeria in scaling up the use of AI-enabled Portable Digital X-ray (PDX) machines to enhance early detection of Tuberculosis (TB), especially among people Living with HIV (PLHIV).

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The Senior Programme Specialist for TB and HIV at CDC Nigeria, Flora Nwagagbo, disclosed this on Wednesday at a media roundtable in Abuja.

Mrs Nwagagbo said the PDX machines are effective in screening for TB, even in people who do not show symptoms.

She noted that the machine can also help diagnose TB in people living with HIV, who face unique diagnostic challenges with traditional TB tests because their immune response is often atypical, making TB harder to detect.

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She said according to global data, an estimated 10.8 million people developed TB in 2023, but 2.6 million were never diagnosed or treated. Among the global TB cases, 662,000 (6.1 per cent) occurred in people living with HIV.

Mrs Nwagagbo said Nigeria remains one of the countries hardest hit, noting that in 2023 alone, the country reported 467,000 new TB cases and 71,000 deaths.

“Alarmingly, about 140,000 of those cases occurred among people living with HIV,” she said.

She added that 4.9 per cent of people living with HIV also have TB, noting that TB remains the leading cause of death among this group because HIV weakens the immune system, increasing the risk of developing active TB.

A deadly disease

TB, an airborne disease caused by bacteria (mycobacterium tuberculosis) mostly affects the lungs. It is the second deadliest infectious killer disease (after COVID-19) and among the top 10 causes of death worldwide.

TB is the leading cause of death among people living with HIV, as the virus weakens the immune system, increasing the risk of active TB infection.

Nigeria ranks sixth globally and first in Africa for TB burden, with the disease remaining one of the country’s top killers.

Diagnosis, treatment

Mrs Nwagagbo lamented that the dual epidemic of TB and HIV presents significant challenges for diagnosis and treatment, as the symptoms of TB can often be obscured by HIV-related illnesses, leading to delays in diagnosis, severe illness, and death.

She explained that systematic screening is an essential first step in TB diagnosis and treatment in eligible populations.

She also said that early detection and prompt treatment can improve health outcomes and prevent severe complications or death.

Mrs Nwagagbo further noted that TB screening may be conducted using portable chest X-ray with artificial intelligence or recommended molecular rapid diagnostic tests, either alone or in combination.

“The use of AI makes the machines faster and more sensitive than traditionally used chest x-rays in detecting abnormalities; reduces time to accurate identification of TB and diagnosis, allowing people to start treatment sooner and improving health outcomes,” she said.

“The use of portable machines maximises the reach of screening activities without needing additional equipment or trained specialists; removes barriers to conducting screening in hard-to-reach areas by allowing for on-site interpretation of images, reducing the need for specialised radiologists; and minimising patient transportation to facilities, which can be very expensive in hard-to-reach areas.”

She stressed that, to ensure effective use of the PDX machines, the US CDC will continue to collaborate with the government and health facilities to deploy the machines across supported states.

Government and partners intensify response

To tackle the epidemic, Mrs Nwagagbo said the Nigerian government established the National TB and Leprosy Control Programme (NTBLCP) and the National AIDS and STIs Control Programme to lead prevention, diagnosis, and treatment efforts.

The Senior Programme Specialist noted that the government also developed surveillance and monitoring systems for data collection and reporting.

She said other efforts include expanding treatment centres to increase case detection and access to treatment, strengthening community awareness and education campaigns and training health workers.

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She said there have also been efforts to improve stakeholder coordination.

“The government has also been training health workers and improve coordination and stakeholders’ engagement,” she said.

The Team Lead of the Programme Management Unit at the NTBLCP, Emperor Ubochioma, expressed deep gratitude to the CDC, the US government, implementing partners, and the media for their support in Nigeria’s fight against TB and HIV.

Mr Ubochioma, represented by the Programme Manager for TB at the NTBLCP, Shadrach Dimang, stressed the importance of awareness and media involvement in dispelling myths and misinformation surrounding TB and HIV.

He noted that breaking the cycle of transmission is key to addressing infectious diseases, with early diagnosis and treatment being the most critical step.

“The AI-aided PDX machines help to improve TB early detection in Nigeria, with their efficiency, objectivity, and ability to reduce human error in diagnosis, especially for difficult cases like those involving immunocompromised patients or children,” he said.