Operational Handbooks

The patient-initiated pathway to TB diagnosis can be enhanced by:

The operational handbook is intended for personnel in national TB programmes and national HIV/ AIDS programmes, or their equivalents, and other relevant national health programmes in ministries of health; other relevant ministries working in public health and screening; other health policy-makers, implementing partners including technical and funding agencies, civil society and representatives of affected communities, clinicians and public health practitioners working on TB and HIV and infectious diseases in the public and private sectors.

Systematic screening for TB fulfils the classic screening criteria (8). The following key principles are to be considered in planning a TB screening initiative:

Note: Unless otherwise specified, the definitions listed below apply to the terms as used in this handbook. They may have different meanings in other contexts.

Active (TB) case-finding: Provider-initiated screening and testing in communities by mobile teams, often using mobile X-ray and rapid molecular tests. The term is sometimes used synonymously with “systematic screening”. It is referred to as “intensified case-finding” when conducted in health-care facilities and as “enhanced case-finding” when conducted in communities.

This operational handbook was prepared by Saskia den Boon and Cecily Miller, with input from Dennis Falzon and Matteo Zignol, under the overall direction of Tereza Kasaeva, Director, WHO Global Tuberculosis Programme. The WHO Global Tuberculosis Programme gratefully acknowledges the contributions of all experts and reviewers involved in the production of the latest update of the WHO guidelines on systematic screening for TB disease, on which this handbook is based, as well as other contributors listed below.

Roadmap

Roadmap towards ending TB in children and adolescents, second edition. Geneva: World Health Organization; 2018 (https://apps.who.int/iris/bitstream/handle/10665/275422/9789241514798-eng.
pdf?sequence=1&isAllowed=y).

WHO operational handbooks

WHO operational handbook on tuberculosis. Module 1: prevention – tuberculosis preventive treatment. Geneva: World Health Organization; 2020 (https://www.who.int/publications/i/item/9789240002906).

Children and adolescents with TB disease frequently present with failure to thrive or weight loss (see Chapter 4). Severe malnutrition is one of the key risk factors for TB in children. Children receiving therapeutic nutritional treatment or nutritional supplementation but still not gaining weight, or continuing to lose weight, should be considered as having a chronic disease such as TB and evaluated accordingly (6).