Opportunity closing date: 
Monday, 12 July, 2021
Opportunity type: 

Terms of Reference
Service Provider for Tuberculosis (TB) screening using Digital Chest X-Rays

The United States Agency for International Development (USAID) Tuberculosis (TB) Local Organizations Network (LON) is a two-year project implemented in partnership with the Government of South Africa, through the South African National Department of Health (NDOH). The project was launched in 2019 by USAID/ Mission in South Africa.
The USAID TB LON Project is using locally generated solutions to improve TB diagnosis, treatment, and prevention services. The TB LON project is implemented by IRD SA NPC, a South Africa section 21 Not-for profit company.  IRD SA is implementing the TB LON Project by delivering a comprehensive package of care services for TB, DR-TB and TB/HIV in the City of Tshwane Metropolitan Municipality (CTMM).
The project is aligned to the South African National Strategic Plan for HIV/AIDS, Sexually Transmitted Infections and TB (2017-2022), and seeks to improve TB prevention and the management of persons with TB, TB/HIV and multidrug-resistant TB (MDR-TB). Specifically, IRD SA team is implementing the TB LON Project through a direct district service delivery integrated comprehensive package of care services for DS-TB, DR-TB and TB/HIV. The LON Project is using a patient-centered approach that is innovative and evidence-based. Including, using the tenets of Search-Treat-Prevent to ensure a comprehensive, free TB initiative in the CTMM. IRD SA team is focusing on increasing TB case finding through TB screening in public health facilities and in the community. In addition to addressing gaps to improve linkage and retention in care—including providing appropriate treatment for latent TB infection (LTBI). Efforts will be underpinned by a robust quality improvement (QI) methodology.
Cases of TB disease will be detected through an initial screening for TB symptoms and chest X-ray of all eligible individuals, and a subsequent bacteriological examination as per the National DS/DR TB Guidelines for those individuals with symptoms suggestive of TB.

  1. To provide chest X-ray services to the TB LON Project by performing digital chest X-rays on approximately 18000 of clients in Tshwane District, over a period of 3 months.
  2. Provide central radiologists’ team to read all chest X-ray and provide written feedback within 48 hours

Specific Tasks to be Performed:

  1. Conduct chest X-rays in high volume facilities and at community level targeting individuals who consent for digital chest X-rays;
  2. Provide the X-ray services for a continuous period of screening activities including weekends as jointly decided by the service provider and IRD SA;
  3. Provide mobile X-ray unit with changing facilities and provision of gowns for clients;
  4. Liaise with the IRD SA project team about scheduled field visits and discuss suitable areas for targeted screening;
  5. Provide mobile digital X-ray unit that is functional and equipped with a generator, electrical supply and back up, relevant equipment and supplies and Lead protection for participants;
  6. Provide full HR for operation of the mobile X-ray unit i.e. a driver/data capturer and radiographer;
  7. Be responsible for the occupational health and safety of its staff;
  8. Ensure Radiation safety regulations are adhered to around the X-ray truck /mobile unit;
  9. Be responsible for the discarding of medical waste as per the regulations;
  10. Provide relief staff and back-up mobile X-ray unit throughout the fieldwork should the need arise, to avoid delays in the field;
  11. Ensure these specifications are met

    1. Digital CXR (PA view) per participant;

    2. Good quality radiograph (in terms of the following - rotation, penetration, inspiration),

    3. and all images correctly labeled as per requirements;

  12. Supervise radiology field teams, provide technical support and troubleshooting
    as and when required throughout the field work;

  13. Provide the required Information Communication Technology (ICT) such as CAD4TB for reading of X-rays and ensure hardware includes

    1. DICOM readers;

    2. Strong router for good connectivity;

    3. Server the ICT should meet the required standards for storage of images, manipulation and survey participant barcode information on site and central,;

    4. Connectivity with sufficient capacity for uploading images to a central data warehouse, daily;

    5. Information system compatible with commonly used survey database;

  14. Provide images for training of own staff and screening team/medical personnel on chest x-ray processes in the community;
  15. Liaise with the IRD SA team throughout the duration of the screening activity;
  16. Participate in all trainings and scheduled meetings throughout the screening activity;
  17. Branding and Marking: The service provider should use USAID TB LON branding in the vehicle.  These can be sticker that can easily removed from the vehicle post the events. It is recommended that we show visibility of USAID TB LON Project;
  18. Recommend the service provider: Should use artificial intelligence (AI) to read chest radiographs for tuberculosis detection. The use of AI in chest X-rays is the most sensitive and cost-efficient way to screen for tuberculosis and other lung diseases.. The service provider should consider use of CAD4TB or qXR which applies deep learning technology to automate the chest X-ray interpretation process.

     Commpulsory Documents:

  1. Company profile
  2. Including telephone number
  3. Including call centre number if applicable
  4. Including general email address
  5. Including website address
  6. Including physical address
  7. Company documents
  8. Company registration
  9. Valid Tax clearance certificate
  10. Proof of VAT registration
  11. Proof of bank account
  12. 3x contactable trade references

Interested companies should submit their detailed sealed bids to our Johannesburg office at Block A 1st floor 36 Wierda Road Wierda West Valley Sandton, South Africa, Att: Charles Makombe. Bids should be submitted not later than Monday 12th July 2021. No late applications will be considered. For more information in regard to the Terms of Reference contact Charles Makombe  on +27 11 326 7583 or email [email protected] 

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