FeedbackConsideration should be given to the extra resources, both human and financial, that will be necessary to prepare for, carry out and monitor screening activities and to accommodate the increased demand for testing of people with presumptive TB and the extra patients who may be identified by screening.
To determine which cadre(s) of staff should be involved in screening, current terms of reference, workload and the capacity of different staff should be reviewed, including supervisory staff and staff that provide commodities (e.g. equipment, software, consumables) for front-line screening workers. Programmatic experience in screening within health facilities and during outreach might provide lessons. There may be opportunities for task-sharing and task-shifting by involving communities (leaders, volunteers, ex-TB patients, civil society agencies, religious groups) and people in the target populations who may be trained in mobilization or even in some of the screening activities. The model of staffing and supervision may be highly context-specific (even within countries) and might vary between urban and rural settings and targeted risk groups.
New data collection systems, preferably electronic, may be required, and training will be necessary. Screening can be done by a variety of personnel, depending on the tests being used. For instance, symptom screening can be conducted by community health workers or volunteers. New diagnostic equipment or additional tests may be required for additional activities. In many cases, the logistics of gaining access to and testing the target population will also require significant resources. If one of the goals of screening is to increase the number of people beginning treatment, it will be important to ensure that there is an adequate supply of medicines for treating TB disease and for prevention; it will also be important to ensure that patients receive adequate support during treatment.