The survey findings also confirmed what many experts suspected – that tens of thousands of people with TB in South Africa are simply never diagnosed. Based on the survey it was estimated that 390 000 people fell ill with TB in the country in 2018 – of which around 154 000 never received a diagnosis.
This would fit with international trends. A mere two months before the release of the survey findings, the World Health Organisation recommended the use of X-ray technology for TB detection but as we reported at the time, some regulatory issues might delay uptake in South Africa.One of the key recommendations from the National TB Prevalence Survey is to increase “access to TB screening and testing services through outreach programmes using mobile testing and X-ray facilities”.
“But it is not more expensive than a floor-fixed model. For the latter, a radiographer and a trained medical officer are also needed,” she says. “Mobile trucks bring one of the most sensitive methods to diagnose TB right to the communities where people live and it gives an immediate result. The image of TB on a chest X-ray is very typical and gives an immediate result,” she explains.
“One of the ways digital chest X-rays will be most important is in deciding who requires a TB test. Now, one of the key ways people are identified for testing for TB is through symptom screening, but as the recent TB Prevalence Survey indicated, people can have TB and not have symptoms. That means we are missing many TB diagnoses. The digital chest X-rays can therefore improve our ability to identify who requires a TB test,” she says.
Western Cape Health MEC Nomafrench Mbombo inspects the equipment inside the mobile X-ray clinic. Picture: WC Health
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