AI X-ray for tuberculosis screening in remote Nepal: Benefits and challenges from a doctor's perspective

Artificial intelligence (AI)-enhanced ultraportable X-ray machines have been recently introduced in our region as tools for community-based pulmonary tuberculosis (TB) screening. Compared to the previously used method of relying solely on "any symptoms of tuberculosis," chest X-ray screening is a more efficient and practical approach. Subclinical TB cases, who often lack overt clinical symptoms, may still be infectious and can present with radiographic abnormalities detectable on chest X-rays. Therefore, a parallel screening strategy combining chest X-rays and symptom assessment, followed by confirmatory sputum testing, is effective in detecting both clinical and subclinical TB cases (with X-ray abnormalities) within the community. The integration of this algorithm, along with AI-assisted portable X-ray devices, represents a significant advancement in community TB screening, although some limitations remain.