Enhanced TB Diagnostic Interventions¶

This module provides advanced TB diagnostic capabilities with stratified parameters and multiple testing methods.

Main Enhanced TB Diagnostic Module¶

Available Classes¶

EnhancedTBDiagnostic: Advanced TB diagnostic intervention with age, state, and HIV-stratified parameters

Key Features¶

Stratified Parameters: Age and TB state-specific sensitivity/specificity
Multiple Diagnostic Methods: Xpert, Oral Swab, FujiLAM, CAD CXR
HIV Integration: HIV-stratified diagnostic parameters
Advanced Testing: Support for various TB testing technologies
Comprehensive Tracking: Detailed diagnostic method and outcome monitoring

Available Diagnostic Methods¶

Xpert MTB/RIF

Adult smear-positive: 90.9% sensitivity, 96.6% specificity
Adult smear-negative: 77.5% sensitivity, 95.8% specificity
Adult extra-pulmonary: 77.5% sensitivity, 95.8% specificity
Children: 73% sensitivity, 95% specificity

Oral Swab Testing

Adult smear-positive: 80% sensitivity, 90% specificity
Adult smear-negative: 30% sensitivity, 98% specificity
Children: 25% sensitivity, 95% specificity

FujiLAM (HIV-focused)

HIV-positive adults: 75% sensitivity, 90% specificity
HIV-negative adults: 58% sensitivity, 98% specificity
HIV-positive children: 57.9% sensitivity, 87.7% specificity
HIV-negative children: 51% sensitivity, 89.5% specificity

CAD CXR (Computer-Aided Detection)

Children: 66% sensitivity, 79% specificity

Usage Examples¶

Basic enhanced diagnostic:

from tbsim.interventions.enhanced_tb_diagnostic import EnhancedTBDiagnostic
from tbsim import TB

# Note: EnhancedTBDiagnostic requires 'sought_care' and 'diagnosed' attributes
# These are typically added by health-seeking interventions
sim = ss.Sim(
    diseases=TB(),
    interventions=EnhancedTBDiagnostic()
)
sim.run()

Advanced diagnostic with multiple methods:

diagnostic = EnhancedTBDiagnostic(
    use_oral_swab=True,      # Enable oral swab testing
    use_fujilam=True,        # Enable FujiLAM for HIV
    use_cadcxr=True,         # Enable CAD CXR for children
    coverage=0.9             # 90% testing coverage
)

Key Methods¶

Diagnostic Management

step(): Execute enhanced diagnostic testing each time step
_get_diagnostic_parameters(): Get stratified sensitivity/specificity
init_results(): Initialize diagnostic result tracking
update_results(): Update results during simulation

Parameter Stratification

Age-based parameters (children vs. adults)
TB state-specific parameters (smear-positive, smear-negative, EPTB)
HIV-stratified parameters for LAM testing
Method-specific parameters for different technologies

Advanced Features¶

Stratified Testing

Different parameters for different population groups
Age-specific diagnostic accuracy
HIV status consideration for LAM testing
TB state-specific testing approaches

Multiple Technologies

Xpert MTB/RIF as primary method
Oral swab for enhanced case detection
FujiLAM for HIV-positive individuals
CAD CXR for pediatric cases

Result Tracking

Diagnostic method used for each test
Stratified outcome analysis
Technology-specific performance metrics
Comprehensive diagnostic pathway analysis

For basic diagnostic capabilities, see the TB Diagnostic Interventions module.