Community-based tuberculosis screening with computer-aided detection technology alone and in combination with point-of-care C-reactive protein testing: a paired screen-positive trial.

In a paired community tuberculosis screening trial in Lesotho and South Africa, CAD4TBv7-CRP detected fewer cases than CAD4TBv7 (82.2% vs 94.5%), failing non-inferiority.

• Why it matters: Community active case-finding is essential but costly and complex, especially in resource-limited health systems, so screening strategies must be evaluated for both yield and cost.
• What they did: In a pragmatic paired screen-positive design, adults in households were screened with CAD4TBv7 on digital chest x-rays, with CAD4TBv7-CRP adding point-of-care CRP when CAD scores fell in a specified range, and Xpert MTB/RIF Ultra used when required.
• The result: Among 73 participants with complete paired primary outcome data, CAD4TBv7-CRP identified 60 cases versus 69 with CAD4TBv7, with a -12.3% difference (95% CI -23.0 to -1.6); it also cost more per detected case ($7486 vs $5454, 37.3% higher).

AI summary of the abstract · may contain errors · not medical advice · read the paper.