2.7.1 Summary of evidence and rationale

Several clinical characteristics, conditions and comorbidities can indicate an increased risk for developing TB disease or suffering worse outcomes from the disease, or both. Individuals identified as having untreated fibrotic lesions on CXR and who are not diagnosed with TB disease are at increased risk of developing TB disease (34–37). These individuals are often identified through TB screening or clinical evaluation or during a clinical evaluation done for other reasons. Individuals with other risk factors for TB or risk factors for poor outcomes from TB often can be identified most easily in health care settings (38–66). Table 2 summarizes the evidence about the primary risk factors for TB and for poor health outcomes related to TB. Groups with other risk factors – such as people with malignancies and other disorders that compromise their immune system and people receiving immunomodulatory therapies – may also be prioritized, depending on the local epidemiology and capacity of the health system.

This recommendation has not been changed from the 2013 guidelines because since the last GDG meeting, no new, robust evidence was found about the impact of systematic screening for TB disease compared with passive case-finding for screening of individuals with risk factors.

 Risk factors for tuberculosis (TB)

BMI: body mass index; COPD: chronic obstructive pulmonary disease; DM: diabetes mellitus; IRR: incidence rate ratio; RR: relative risk.

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