Zimbabwe rolls out advanced TB detection technology in high-risk areas

Zimbabwe has launched a groundbreaking health initiative aimed at strengthening the fight against tuberculosis (TB) and related lung conditions through early detection in high-burden communities. The programme, which incorporates artificial intelligence and ultra-portable radiology, seeks to screen over 12,000 people in its first 100 days, with an investment of US$550,000.

Spearheaded by the Ministry of Health and Child Care in collaboration with The Union Zimbabwe Trust (UZT), the CUFF-TB project - short for CAD-AI, Ultra-portable Radiology, and Field-Based Diagnosis for TB - targets the mining districts of Zvishavane and Mberengwa in Midlands Province. These areas have been identified as TB hotspots, particularly due to artisanal and small-scale mining activities, which pose elevated risks for lung-related illnesses such as silicosis.

UZT executive director, Dr Ronald Ncube, said the initiative goes beyond TB to address other critical co-morbidities and social determinants of health.

"The CUFF-TB project integrates TB screening with lung health services and screening for silicosis, alcohol use disorders, and malnutrition," said Dr Ncube. "The goal is to reduce both morbidity and mortality through early detection and timely treatment, especially in under-served populations."

The innovative approach includes ultra-portable X-ray machines enhanced with artificial intelligence to assist in diagnosing TB and other lung abnormalities, as well as rapid molecular testing via the Truenat platform. These tools are being deployed through mobile field laboratories, enabling the delivery of life-saving diagnostics at community level - including remote and informal mining sites where access to healthcare is often limited.

Dr Ncube noted that CUFF-TB represents a shift from a passive, facility-based disease response to a proactive, integrated and community-focused strategy.

"By implementing moonlight screenings at night-time social venues and mining sites, we're reaching communities where they are, rather than waiting for them to come to us," he said.

The CUFF-TB project has already seen significant groundwork laid. Four provincial project officers and a core technical team - including a radiographer, laboratory technician and data clerk - were recruited in May 2025. An operations hub has been established at Zvishavane District Hospital, and key equipment such as digital X-ray units and Truenat diagnostic machines have been installed.

Training has also been a major focus. A total of 270 community health workers and healthcare staff were trained across five clusters to support moonlight screenings, community engagement, and follow-up care. These frontline workers are playing a vital role in mobilising local participation and ensuring continuity of care.

Dr Ncube emphasised that strong stakeholder engagement has underpinned the success of the rollout. Sensitisation meetings were held with provincial and district health managers to align the project with national priorities. Community leaders in Zvishavane and Mberengwa were also engaged through local dialogues to foster trust, encourage participation, and build local ownership of the programme.

A major technical advancement was achieved in March 2025, when Zimbabwe's TB diagnostic protocol was officially revised to incorporate routine screening for silicosis, malnutrition, and alcohol use disorders. This has laid the foundation for a more holistic approach to lung health at the primary healthcare level.

"This pilot will generate critical evidence to inform the integration of community-based screening into national programming," Dr Ncube said. "It's not just about detecting TB - it's about delivering people-centred healthcare that addresses the real conditions people are living in."

The CUFF-TB project is widely seen as a scalable, high-impact model that could transform community health responses across Zimbabwe and in other countries facing similar health burdens.