A Protocol on “Improving Tuberculosis Detection and Accelerating Elimination through Digital Hand-Held X-Ray Units for Pre-Diagnosis Screening in Rural Communities: An Implementation Research in a Health Block of District Kangra, Himachal Pradesh, In

Abstract Background: Given the national imperative to eliminate tuberculosis (TB) in India and the need to foster an adaptable healthcare system, an implementation research study is proposed. The study is planned with the objective to assess the feasibility of improving access to point-of-care TB screening in underserved populations through the strategic deployment of hand-held X-ray technology. Materials and Methods: Implementation research with a Community Health Center (CHC)-based three-stepped wedge design will be used. After conducting formative research as part of phase 1 of study, a staggered intervention (hand-held X-ray) will be introduced across CHCs using a stepped wedge design during phase 2 of the study. Phase 3 will include evaluation and end-line assessment. Results: Metrics and processes like the proportion of TB patients screened, improved TB detection rates, and treatment outcomes will be evaluated. Conclusion: The research will evaluate the effectiveness of integrating hand-held X-ray units in routine TB screening programs, thereby providing valuable insights into its feasibility and adaptability in our healthcare system to combat TB in India and other resource-limited settings.