Portable X-Ray as A Strategy for the Prevention and Control of Pulmonary Tuberculosis: A Systematic Review

Abstract

Pulmonary tuberculosis (TB) remains a global public health problem with high morbidity and mortality rates, particularly in developing countries. Indonesia has the second-highest number of cases in the world, with East Nusa Tenggara (NTT) as one of the provinces with the highest number of cases nationally. Early detection is a key component of TB prevention and control strategies, but limited access to conventional radiology facilities is a major obstacle, particularly in remote areas such as NTT. The use of portable X-ray technology is considered a potential innovation to expand screening coverage and accelerate the diagnosis of pulmonary TB. This study aims to systematically analyze the role and effectiveness of portable X-ray use as a strategy for preventing and controlling pulmonary tuberculosis. The method used was a systematic review by examining scientific articles published in electronic databases such as PubMed, Scopus, and Google Scholar within a specific publication year. Inclusion criteria included studies discussing the use of portable X-rays in the screening, early diagnosis, and control of pulmonary tuberculosis in the general population and high-risk groups. The article selection process followed the PRISMA guidelines. The review results show that the use of portable X-ray significantly increases access to pulmonary TB screening, especially in areas with limited health infrastructure. Several studies report relatively high sensitivity and specificity in detecting lung abnormalities suggestive of TB, especially when combined with Computer-Aided Detection (CAD) technology. Furthermore, the implementation of portable X-ray has proven effective in supporting mass screening activities, active case detection, and accelerating referrals for further bacteriological examination. Challenges identified include the need for operator training, the initial cost of equipment procurement, and radiation safety aspects. Portable X-ray is an effective and innovative strategy for preventing and controlling pulmonary tuberculosis, particularly in improving early detection and reaching populations with limited access to healthcare. Integrating this technology into the national TB program requires radiation safety regulations, increased healthcare worker capacity, and ongoing policy support.