Systematic Screening for Active Tuberculosis : Principles and Recommendations.

Cover -- Contents -- Foreword -- Acknowledgements -- Executive summary -- Abbreviations -- Definitions -- 1. Purpose of guideline and target audience -- 1.1 Purpose -- 1.2 Target audience -- 2. Definition of screening for active TB in risk groups -- 2.1 Systematic screening for active TB -- 2.2 Risk groups -- 3. Rationale and objectives of screening for active TB -- 3.1 Challenges to TB care and control -- Large pool of undetected TB -- Limitations of passive case-finding using sputum-smear microscopy -- Reaching the poorest people more effectively -- Detecting TB early in other vulnerable groups -- 3.2 Objectives and goals of screening for active TB -- 4. Guideline development process -- 4.1 Scoping, Guideline Development Group and peer review -- 4.2 GRADE tables and Decision tables -- 4.3 Grading the recommendations -- 4.4 Proposed subsidiary guideline products and implementation plan -- 5. Summaries of the systematic reviews -- 5.1 Review 1: systematic review of the benefits of screening for active TB to communities and individuals -- 5.2 Review 2: systematic review of the sensitivity and specificity of different screening tools and algorithms -- Screening in adults -- Screening in children -- 5.3 Review 3: systematic review of the number needed to screen in different risk groups -- 5.4 Review 4: systematic review of the acceptability of screening -- 6. Assessing TB screening against generic criteria for screening -- 7. Key principles for screening for active TB -- 8. Recommendations on risk groups to be screened for active TB -- 8.1 Strong recommendations -- 8.2 Conditional recommendations -- 9. Algorithms for screening and diagnosis -- 9.1 Screening adults and children aged 10 years and older -- 9.2 Screening children younger than 10 years -- 10. Monitoring and evaluation -- 10.1 Proposed indicators.

10.2 Routines for recording and reporting -- 10.3 Programmatic evaluations -- 10.4 Monitoring time trends for reprioritization -- 10.5 Research -- Annex I. GRADE summary table: benefits of screening for tuberculosis, all risk groups combined -- Annex II. GRADE summary tables: sensitivity and specificity of screening tools for tuberculosis -- Annex III. Flow charts of algorithms for screening and diagnosing tuberculosis in adults with modelled yields and predictive values -- Annex IV. Guideline Development Group, WHO secretariat and peer reviewers.

There have been calls to revisit the experiences of TB screening campaigns that were widely applied in Europe and North America in the mid-20th century as well as more recent experiences with TB screening in countries with a high burden of the disease and to assess their possible relevance for TB care and prevention in the 21st century. _x000D__x000D_ _x000D__x000D_ In response WHO has developed guidelines on screening for active TB. An extensive review of the evidence has been undertaken. The review suggests that screening if done in the right way and targeting the right people may reduce suffering and death but the review also highlights several reasons to be cautious. As discussed in detail in this document there is a need to balance potential benefits against the risks and costs of screening; this conclusion is mirrored by the history of TB screening. _x000D__x000D_ _x000D__x000D_ This document presents the first comprehensive assessment by WHO of the appropriateness of screening for active TB since the recommendations made in 1974 by the Expert Committee. However the relative effectiveness and cost effectiveness of screening remain uncertain a point that is underscored by the systematic reviews presented in this guideline. Evidence suggests that some risk groups should always be screened whereas the prioritization of other risk groups as well as the choice of screening approach depend on the epidemiology the health-system context and the resources available. _x000D__x000D_ _x000D__x000D_ This document sets out basic principles for prioritizing risk groups and choosing a screening approach; it also emphasizes the importance of assessing the epidemiological situation adapting approaches to local situations integrating TB screening into other health-promotion activities minimizing the risk of harm to individuals and engaging in continual

monitoring and evaluation. It calls for more and better research to assess the impact of screening and to develop and evaluate new screening tests and approaches. _x000D__x000D_.

Description based on publisher supplied metadata and other sources.

Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2024. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries.