Semarang City Implements AI-Enhanced Mobile X-Ray for TB Detection

The Semarang City Government in Central Java, Indonesia, has launched an innovative initiative utilizing AI-powered portable X-ray machines to enhance the detection and treatment of tuberculosis (TB) cases. With Indonesia reporting approximately 1,090,000 TB cases and 125,000 deaths annually, a figure that ranks second only to India according to the World Health Organization's (WHO) Global TB Report 2024, the urgency for effective TB management is paramount.

To combat the TB epidemic, the Semarang City Government has adopted an active case finding (ACF) strategy aimed at improving early detection and screening among high-risk groups. Anggun Wandastuti, Head of the Infectious Disease Control Working Group (P2ML) at the Semarang City Health Department, emphasized the importance of this proactive approach in reducing transmission rates and ensuring timely treatment for individuals who have yet to receive care. "With ACF, we hope to identify hidden TB patients. When treated promptly, the risk of transmission to others becomes minimal," Wandastuti stated in an interview with GovInsider.

Unlike traditional passive case finding, where patients seek care based on symptoms, ACF involves systematic screenings in communities targeting high-risk individuals, such as household contacts of TB patients. The portable X-ray devices, funded by the Government of the United Arab Emirates (UAE), are compact, emit minimal radiation, and are portable enough to be used in various settings, including ordinary rooms. This technology not only facilitates immediate digital access to results through the Tuberculosis Information System (SITB) but also significantly accelerates the diagnostic process compared to previous methods that relied heavily on radiologists.

Since the program's inception in March 2025, the Semarang City Health Department has conducted 30 mobile screenings across 16 districts, examining approximately 2,700 individuals, of whom 27 tested positive for TB. Those diagnosed are placed on a six-month treatment regimen, closely monitored by local healthcare facilities (Puskesmas) to ensure adherence to medication and prevent drug resistance, a major challenge in TB treatment.

In addition to identifying active TB cases, the ACF program also emphasizes preventive measures. Individuals with negative X-ray results or asymptomatic individuals with a history of close contact with TB patients are recommended for TB preventive therapy. Wandastuti noted, "This is crucial because TB infection can remain dormant and could become active if the individual's health deteriorates." Additional diagnostic tests, such as the Mantoux test, are also utilized to detect latent TB infections, particularly in diverse target groups including individuals with diabetes, HIV, active smokers, and those experiencing nutritional issues.

Despite the program's potential, challenges remain, particularly concerning the limited coverage provided by Indonesia's National Health Insurance (JKN). Currently, the insurance covers examinations only for patients presenting symptoms or confirmed TB cases. Wandastuti advocates for the inclusion of preventive therapy in JKN coverage, which would allow for broader screening of asymptomatic individuals. Fortunately, the central government has allocated funding for TB preventive therapy in the 2025 state budget, as Semarang City has been designated as one of 25 regions across eight provinces to implement the ACF program.

Looking to the future, Wandastuti envisions a scenario where portable X-ray devices are readily available within local governments, despite their high cost, estimated at IDR 3–4 billion (approximately S$237,000-314,000) per unit. Community member Nasiyatin shared her positive experience with the ACF program, expressing relief upon receiving quick X-ray results that confirmed she was not infected with TB. "This screening is free, and you can register simply with your ID card," she remarked, highlighting the initiative's accessibility and community impact.

The introduction of AI-powered portable X-ray technology in Semarang City represents a significant advancement in the fight against tuberculosis, showcasing how innovative solutions can address public health challenges effectively. The success of this initiative may serve as a model for other regions grappling with similar health crises, ultimately aiming to reduce the global burden of TB.