Screening

11. Among adults and adolescents living with HIV, systematic screening for TB disease should be conducted using the WHO-recommended four symptom screen and those who report any one of the symptoms of current cough, fever, weight loss or night sweats may have TB and should be evaluated for TB and other diseases

(existing recommendation: strong recommendation, moderate certainty of evidence).

12. Among adults and adolescents living with HIV, C-reactive protein with a cut-off of > 5 mg/L may be used to screen for TB disease

10. Among individuals aged 15 years and older in populations in which TB screening is recommended, computer-aided detection software programmes may be used in place of human readers for interpreting digital chest X-rays for screening and triage for TB disease

(new recommendation: conditional recommendation, low certainty of evidence).

9. Among individuals aged 15 years and older in populations in which TB screening is recommended, systematic screening for TB disease may be conducted using a symptom screen, chest X-ray or molecular WHO-recommended rapid diagnostic tests, alone or in combination

(new recommendation: conditional recommendation, very low certainty of evidence for test accuracy).

7. In settings where the TB prevalence in the general population is 100/100 000 population or higher, systematic screening for TB disease may be conducted among people with a risk factor for TB who are either seeking health care or who are already in care

(existing recommendation: conditional recommendation, very low certainty of evidence).

8. People with an untreated fibrotic lesion seen on chest X-ray may be systematically screened for TB disease

6. Current and former workers in workplaces with silica exposure should be systematically screened for TB disease

(existing recommendation: strong recommendation, low certainty of evidence).

5. Systematic screening for TB disease should be conducted in prisons and penitentiary institutions

(updated recommendation: strong recommendation, very low certainty of evidence).

4. Household contacts and other close contacts of individuals with TB disease should be systematically screened for TB disease

(updated recommendation: strong recommendation, moderate certainty of evidence).

3. People living with HIV should be systematically screened for TB disease at each visit to a health facility

(existing recommendation: strong recommendation, very low certainty of evidence).

2. Systematic screening for TB disease may be conducted among subpopulations with structural risk factors for TB. These include urban poor communities, homeless communities, communities in remote or isolated areas, indigenous populations, migrants, refugees, internally displaced persons and other vulnerable or marginalized groups with limited access to health care

(existing recommendation: conditional recommendation, very low certainty of evidence).

1. Systematic screening for TB disease may be conducted among the general population in areas with an estimated TB prevalence of 0.5% or higher

(updated recommendation: conditional recommendation, low certainty of evidence).