FeedbackThe acceptability and feasibility of screening for those who will be screened and those who will provide screening should be assessed. Whether screening is accepted depends on how the programme is designed and implemented. Acceptability is therefore difficult to predict from evidence for other sites or for other subgroups. The acceptability of screening may be assessed in advance by organizing focus groups of target populations, preferably with a risk profile and an age and sex distribution that matches that of the populations at highest risk. Consulting and working with affected communities and local civil society organizations that support them throughout the development and implementation of TB screening interventions will help to ensure that they meet the needs and expectations of communities and that they are accepted.
Some people may accept screening more readily than others, depending on the perceived cost and inconvenience, as well as the adverse consequences of participating in screening or of a TB diagnosis (such as stigmatization or discrimination) as compared with the perceived benefits. TB screening is generally acceptable to most people (see more information in the Web Annexes B and C of the screening guidelines).
Certain risk groups are more difficult to reach than others. To some extent, the structure of health and social services determines which risk groups can be reached most easily. Generally, it is more feasible to conduct screening in well-defined risk groups that can be reached in a specific location, such as clinical risk groups within health facilities, people living in institutions (such as prisons) and people working in high-risk locations (such as mines). A screening intervention should not reduce health equity throughout the health services; therefore, any effort to screen hard-to-reach populations should be matched with appropriate resource mobilization.