2.3 Setting goals and specific objectives

The primary goal of TB screening is to reach people who are not reached by the patient-initiated pathway and to detect TB disease early, thereby improving outcomes for individuals and reducing transmission and incidence at population level.

Secondary goals of TB screening are to:

  • rule out TB disease in order to identify people who are eligible for TPT (4, 5);
  • identify people who are at particularly high risk of developing TB disease and thus may require repeated screening, such as people with an abnormal CXR (e.g. fibrotic lesion) that is compatible with TB but who were not diagnosed with TB disease at the time of screening, people living with HIV, health-care workers and prisoners; and
  • better characterize TB risk factors by combining screening for TB with screening for TB risk factors (such as HIV, diabetes mellitus, chronic obstructive pulmonary disease, undernutrition or smoking) to map individual or community-level risk factors and socioeconomic determinants that should be addressed to prevent the disease more effectively. This may be an additional objective in settings where information about the prevalence and distribution of TB risk factors is lacking.

Specific objectives can be based on those goals and according to a country’s priorities and situation assessment. They may be based on specific targets or gaps identified in the situation assessment. The objectives should be specific, measurable, achievable, relevant and time-bound (SMART). 

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