The rating schemes for the quality of the evidence (high, moderate, low, very low) and the strength of the recommendations (strong, conditional) are defined at the end of the "Major Recommendations" field.
Key Principles for Screening for Active Tuberculosis (TB)
The following key principles should be considered when planning a TB screening initiative.
- Before screening is initiated, high-quality TB diagnosis, treatment, care, management and support for patients should be in place, and there should be the capacity to scale these up further to match the anticipated rise in case detection that may occur as a result of screening. In addition, a baseline analysis should be completed in order to demonstrate that the potential benefits of screening clearly outweigh the risks of doing harm, and that the required investments in screening are reasonable in relation to the expected benefits.
- Indiscriminate mass screening should be avoided. The prioritization of risk groups for screening should be based on assessments made for each risk group of the potential benefits and harms, the feasibility of the initiative, the acceptability of the approach, the number needed to screen, and the cost effectiveness of screening.
- The choice of algorithm for screening and diagnosis should be based on an assessment of the accuracy of the algorithm for each risk group considered, as well as the availability, feasibility and cost of the tests.
- TB screening should follow established ethical principles for screening for infectious diseases, observe human rights, and be designed to minimize the risk of discomfort, pain, stigma and discrimination.
- The TB screening approach should be developed and implemented in a way that optimizes synergies with the delivery of other health services and social services.
- A screening strategy should be monitored and reassessed continually to inform re-prioritization of risk groups, re-adaptation of screening approaches when necessary and discontinuation of screening at an appropriate time.
See section 7 in the original guideline document for details on the key principles.
Recommendations on Risk Groups to Be Screened for Active TB ....
