1.1 Background

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) (1). WHO’s End TB Strategy envisions a 90% reduction in TB incidence and a 95% reduction in TB deaths by 2035 (2, 3), and the Declaration adopted by the United Nations General Assembly in September 2018 at the High-Level Meeting on the Fight Against Tuberculosis commits to diagnosing and treating 40 million people with TB by 2022 (4). In order to achieve these ambitious targets, there is an urgent need to deploy strategies to improve the diagnosis and initiation of care for people with TB. One key strategy is systematic screening for TB disease, which is included in the End TB Strategy as a central component of its first pillar, aimed at ensuring early diagnosis for all with TB.

To help facilitate the implementation of TB screening at the country level, WHO published guidelines on systematic screening for TB in 2013 (5). Since then, there have been important new studies evaluating the impact of screening interventions on both individual-level and community-level outcomes related to TB, as well as new research evaluating innovative tools for screening for TB among important populations at high risk for TB disease. In light of these new developments and continual requests by Member States for guidance on how to conduct effective TB screening, in 2020 WHO convened a Guideline Development Group (GDG) to examine the evidence in order to update WHO’s guidelines and recommendations for screening for TB disease.

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