WHO consolidated guidelines on tuberculosis Module 2: Screening – Systematic screening for tuberculosis disease

22 Mar 2021
Guidelines

Background

Tuberculosis (TB) is a leading cause of death from a single infectious agent, despite being 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 Organization. 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 by 2022. In order to achieve this ambitious target, 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 help facilitate the implementation of TB screening at the country level, WHO published guidelines on screening for TB in 2013. 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.

Overview

In view of these new developments and upon demand by countries for more guidance, WHO convened a Guideline Development Group (GDG) in 2020 to examine the evidence and prepare WHO consolidated guidelines on tuberculosis. Module 2: Screening - Systematic screening for tuberculosis disease. As a result of this process a set of 17 new and updated recommendations for the screening of TB disease have been developed. These recommendations identify contacts of TB patients, people living with HIV, people exposed to silica, prisoners and other key populations to be prioritized for TB screening. The new guidance also recommends different tools for screening, namely symptom screening, chest radiography, computer-aided detection software, molecular WHO-approved rapid diagnostic tests, and C-reactive protein. The new recommendations are being released as part of a modular series of WHO guidance on TB and are accompanied by a complementary implementation guide.