Rapid communication on systematic screening for tuberculosis

Publication Year 28 Aug 2023

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Background

Tuberculosis (TB) is the leading cause of death from a single infectious agent even if is largely curable and preventable. In 2019 an estimated 2.9 million of the 10 million people who fell ill with TB were not diagnosed or reported to the World Health Organization1. The Political Declaration adopted by the United Nations General Assembly in September 2018 commits, amongst others, to diagnosing and treating 40 million people with TB. In order to achieve these ambitious targets, there is an urgent need to deploy strategies to improve diagnosis and initiation of care for people with TB. One of them is systematic screening for TB disease, which is included in the End TB Strategy as a central component of its first pillar to ensure early diagnosis for all with TB.
To facilitate the implementation of TB screening at the country level, the World Health Organization (WHO) published guidelines on screening for TB in 20132. Since then, there have been important new studies evaluating the impact of screening interventions on both individual-level and community-level outcomes related to TB, as well as new research evaluating innovative tools for screening for TB among important populations at high risk for TB disease, including the use of computer-aided detection of TB on digital radiographs, C-reactive protein and WHO-approved rapid molecular diagnostic tests for TB.
In the light of these new developments and according to the request by Member States in 2020 WHO convened a Guideline Development Group (GDG) to examine the evidence in order to update the Systematic screening for active tuberculosis: principles and recommendations of 2013. The Group met in virtual sessions between June and October 2020 and proposed several new recommendations related to TB screening. The preparation and review of the new WHO consolidated guidelines on tuberculosis: Module 2: Screening – systematic screening for tuberculosis disease are in process and they are scheduled to be released in March 2021, alongside an operational handbook. WHO gratefully acknowledges the work of the GDG members, the evidence reviewers, national TB and HIV programmes, WHO colleagues, technical and funding partners, civil society, patients and all others who contributed to the data to inform this guideline update.
This Rapid Communication is being issued to help national TB programmes and other stakeholders prepare for the changes that will be introduced with the new guidelines on TB screening.