Title : Leveraging portable digital X-ray and artificial intelligence for active tuberculosis case finding among people living with HIV in Nepal
Abstract:
Background: Tuberculosis remains a leading cause of death among people living with HIV. Nepal faces a high TB burden with limited early detection tools for high-risk groups. This study aimed to screen TB among PLHIV using portable digital X-ray with Computer-Aided Detection.
Methods: A cross-sectional study was conducted among 260 HIV-positive patients in Gandaki Province to assess TB using digital chest X-ray and confirm presumptive cases with GeneXpert at the Provincial Center for Disease Control. Ethical approval was obtained from Pokhara University’s Institutional Review Committee.
Results: Fourteen percent of participants were found to be suggestive of active or old TB on digital chest X-ray. Of the 37 presumptive cases tested by Gene-Xpert, 16.2% were MTB -positive. Gene-Xpert positivity rate was 18.92% with overall TB prevalence as 2.69%. Sex, ethnicity, alcohol use, comorbidities, viral load, symptoms and close contact showed association with TB infection in bivariate analysis whereas Dalit ethnic group was identified as main predictor for TB among PLHIV.
Conclusion: This study determined TB prevalence and associated risk factors among PLHIV in Nepal, highlighting the significance of portable digital X-ray for active TB screening, guide targeted group interventions, ensure timely treatment and support TB elimination goal.
Keywords: Digital X-ray, Tuberculosis, Human Immunodeficiency Virus, Acquired Immunodeficiency Syndrome
