The evidence reviewed about the performance of symptom screening (any one of current cough, fever, poor weight gain or close contact with someone with TB) included 2 studies conducted in the outpatient setting with a total of 20 926 participants and including 20 3135 screens (see Web Annex B, Table 19, and Web Annex C, Table 10). In this setting, the combined symptom screen (where the presence of any symptom constitutes a positive screen) was found to have a pooled sensitivity of 0.61 (95% CI: 0.58–0.64) and a pooled specificity of 0.94 (95% CI: 0.86–0.98).
Again, despite the absence of high-certainty evidence, the GDG felt that a strong recommendation was warranted for symptom screening for children younger than 10 years who are living with HIV, given the high risk of disease and of mortality if the diagnosis is missed and TB is left untreated.