Screening

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.

1. Global tuberculosis report 2020. Geneva: World Health Organization; 2020 (https://apps.who.int/iris/ bitstream/handle/10665/336069/9789240013131-eng.pdf, accessed 19 February 2021).

2. Uplekar M, Weil D, Lönnroth K, Jaramillo E, Lienhardt C, Dias HM, et al. WHO’s new End TB Strategy. Lancet. 2015;385:1799–801. doi:10.1016/s0140–6736(15)60570–0.

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 (WHO). The Political Declaration adopted by the United Nations General Assembly in September 2018 at the High-Level Meeting on the Fight Against Tuberculosis commits to, among other goals, diagnosing and treating 40 million people with TB by 2022.