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TB Screening Tools
Learning ObjectivesEnlist various screening tools for TB and briefly mention its place in the screening process.
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Screening for active tuberculosis (TB) should be done with a tool that:
- Effectively identifies people who probably have active TB
- Has high sensitivity (very high specificity is not necessary for a screening tool)
- Needs to be inexpensive
- Should be feasible to use in a given setting
- Is acceptable to a given risk group.
Options for the screening for TB include:
- Screening for symptoms: Screening either for cough lasting for longer than 2 weeks, or screening for any symptom compatible with TB, including cough of any duration, haemoptysis, weight loss, fever or night sweats.
- Screening with chest radiography: Often used as a second screen to improve the pre-test probability of the subsequent diagnostic test, and to reduce the number of people who need to undergo further diagnostic evaluation.
If the screening test like chest X-ray is positive, then such patients are sent for TB diagnostic tests. This can be either sputum-smear microscopy or a rapid molecular test that has been demonstrated to have high accuracy for both smear-positive and smear-negative pulmonary TB, such as the CBNAAT test, or further culture and drug-susceptibility testing, as is required.
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