FeedbackDepending on the objectives of the screening programme and the results of monitoring the indicators discussed above, a special assessment may be necessary to determine, for example, the reasons for low uptake of screening, an unexpectedly low proportion of people presumed to have TB identified by screening, a low proportion of those presumed to have TB who were further evaluated for TB, a higher-than-expected NNS or a high proportion of cases that are not bacteriologically confirmed. Programmes are unlikely to be able to replicate the performance observed in trials and other studies conducted under controlled conditions, in which study subjects may even have been pre-screened.
Additional quantitative and qualitative analyses may be necessary to determine whether there are barriers to screening, to identify opportunities to improve the screening approach and whether there have been any social or financial consequences of screening (e.g. costs of CXR and travel shifted to patients). It is also prudent to evaluate the effects of screening on overall operations at health clinics, especially the impact of an increased burden of laboratory testing.