ReacciónThe production of the WHO consolidated guidelines on tuberculosis. Module 2: screening was coordinated and written by Cecily Miller, with support from Annabel Baddeley, Dennis Falzon and Matteo Zignol, under the overall direction of Tereza Kasaeva, Director of the World Health Organization (WHO) Global Tuberculosis Programme. The WHO Global Tuberculosis Programme gratefully acknowledges the contribution of all experts involved in producing these guidelines¹. This update was funded by grants provided to WHO by the United States Agency for International Development and the Russian Federation.
Guideline Development Group
The Guideline Development Group (GDG) was composed of Denise Arakaki-Sanchez (Ministry of Health, Brazil), Omolola Atalabi (University College Hospital, Ibadan, Nigeria), Helen Ayles (London School of Hygiene and Tropical Medicine, England, and Zambart, Zambia), David Branigan (Treatment Action Group, United States of America), Jeremiah Chakaya (The UNION [the International Union Against Tuberculosis and Lung Disease], Kenya), Gavin Churchyard (The Aurum Institute, South Africa), Elizabeth Corbett (London School of Hygiene and Tropical Medicine, England, and Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Malawi), Anand Date (Centers for Disease Control and Prevention, USA), Esty Febriani (Civil Society Task Force, Indonesia), Celine Garfin (National TB Programme, Philippines), Amir M Khan (Association for Social Development, Pakistan), Katharina Kranzer (London School of Hygiene and Tropical Medicine, England), Tamara Kredo (University of Cape Town, South Africa), Knut Lönnroth (Karolinska Institute, Sweden), Guy Marks (University of Sydney, Australia), Andrey Maryandyshev (Northern State Medical University, Russian Federation), David Mungai (Civil Society Task Force, Kenya), Iveta Ozere (Centre of Tuberculosis and Lung Diseases, Latvia), Alena Skrahina (National TB Programme, Belarus) and Marieke J van der Werf (European Centre for Disease Prevention and Control, Sweden). Jeremiah Chakaya and Tamara Kredo co-chaired the GDG meetings.
External Reviewer Group
The external reviewers were Grania Brigden (The UNION, France), Connie Erkens (Tuberculosis Foundation [KNCV], Netherlands), Andrew Kerkhoff (University of California, San Francisco, USA), Giovanni B Migliori (Maugeri Care and Research Institute, Italy), Ikushi Onozaki (Japan Anti-TB Association, Japan), Srinath Satyanarayana (The UNION, India), James Seddon (Imperial College London, England), Ivan Solovic (National TB Programme, Slovakia) and Sabira Tahseen (National TB Reference Laboratory, Pakistan).
Evidence reviewers
The following persons contributed to the reviews and summarized evidence for the guidelines using the Population, Intervention, Comparator and Outcomes (PICO) framework (see Section 1.3 for more information about the PICO questions).
PICO questions 1–4 (individual effects of screening): Lily Telisinghe, Maria Ruperez, Tila Mainga, Modope Amofa-Seki, Lawrence Mwenge, Virginia Bond, Ramya Kumar, Cyrus Daneshvar and Maged Hassan (London School of Hygiene and Tropical Medicine, England and Zambart, Zambia); and Eveline Klinkenberg (independent consultant, Netherlands).
PICO questions 5–7 (community effects of screening): Peter MacPherson, Marriott Nliwasa, Rachael Burke and Helene Feasy (Liverpool School of Tropical Medicine, England and Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Malawi).
PICO question 8 (accuracy of screening approaches in people living with HIV): Gary Maartens and Ashar Dhana (University of Cape Town, South Africa).
PICO question 9 (accuracy of screening approaches in the general population): Anja Van’t Hoog (Amsterdam Institute for Global Health and Development, Netherlands), Miranda Langendam and Ba Da Yang (Amsterdam University Medical Centre), and Olivia Biermann (Karolinska Institute, Sweden).
PICO question 10 (accuracy of screening approaches in children and adolescents): Anna Mandalakas, Tara Ness and Bryan Vonasek (Baylor College of Medicine, USA); and Karen Steingart (Cochrane Infectious Diseases Group, Liverpool School of Tropical Medicine).
PICO question 11 (accuracy of computer-aided detection software): Sandra Kik, Morten Ruhwald, Claudia Denkinger, Stefano Ongarello and Samuel Schumacher (Foundation for Innovative New Diagnostics, Switzerland); Faiz Ahmad Khan, Mikashmi Kohli and Gamuchirai Tavaziva (McGill University, Canada); Sifrash Gelaw (International Organization for Migration, Philippines); and Jacob Creswell and Zhi Zhen Qin (Stop TB Partnership, Switzerland).
PICO question 12 (accuracy of molecular WHO-recommended rapid diagnostic tests for screening): Adrienne Shapiro (University of Washington, USA) and Karen Steingart (Cochrane Infectious Diseases Group, Liverpool School of Tropical Medicine).
PICO question 13 (number needed to screen in general and high-risk groups): Lelia Chaisson University of Illinois at Chicago, USA); Jonathan Golub, Fahd Naufal, Katherine Robsky, Hector Manzo and Pamela Delgado (Johns Hopkins University, USA); and Adrienne Shapiro (University of Washington, USA)
PICO question 14 (number needed to screen and effectiveness of screening in contacts): Gregory Fox and Kavindhran Velen (University of Sydney, Australia), Mariana Velleca (University of California San Francisco, USA).
PICO question 15 (risk factors for TB): Rafia Bosan (Harvard University, USA) and Lelia Chaisson (University of Illinois at Chicago, USA).
PICO question 16 (costs and cost–effectiveness of TB screening): Hannah Alsdurf, Brianna Empringham and Alice Zwerling (University of Ottawa, Canada).
PICO question 17 (community perceptions of TB screening): Paul Garner and Nancy Medley (Liverpool School of Tropical Medicine, England).
WHO Guideline Steering Group
The WHO Guideline Steering Group was composed of Annabel Baddeley, Dennis Falzon, Avinash Kanchar, Alexei Korobitsyn, Cecily Miller, Nobu Nishikiori, Linh N Nguyen, Sabine Verkuijl and Matteo Zignol (WHO Global Tuberculosis Programme); Satvinder Singh and Lara Vojnov (WHO Global HIV, Hepatitis and Sexually Transmitted Infections Programme); Andreas Reis (Department of Health Ethics and Governance); Maria del Rosario Perez (Department of Radiation and Health); Farai Mavhunga (WHO Regional Office for Africa); Muhammad Akhtar (WHO Regional Office for the Eastern Mediterranean); Mukta Sharma (WHO Regional Office for South-East Asia); Tauhidul Islam (WHO Regional Office for the Western Pacific); and Askar Yedilbayev (WHO Regional Office for Europe).
Others
Holger Schünemann (McMaster University, Canada) served as the technical resource person on GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. The following persons participated as observers at the GDG meetings: Sevim Ahmedov and Charlotte Colvin (United States Agency for International Development, USA), Draurio Barreira Cravo Neto (Unitaid, Switzerland), Olivia Bierman (Karolinska Institute, Sweden), Michael Campbell (Clinton Health Access Initiative, USA), Pierre-Marie David (Université de Montréal, Canada), Christopher Gilpin (International Organization for Migration, Switzerland), Brian Kaiser (Global Drug Facility, Switzerland) and Mohammed Yassin (Global Fund to Fight AIDS, Tuberculosis and Malaria, Switzerland). Kerri Viney (WHO Global Tuberculosis Programme) contributed to the reviews on the accuracy of screening approaches in the general population. The document was edited by Miriam Pinchuk. The Global Tuberculosis Programme also thanks the Guideline Review Committee and its WHO secretariat for their review and approval of the guidelines.
¹ More information about the areas of expertise, and the gender and geographical distribution of participants as well as declarations of interests and the management of potential conflicts for members of the GDG and External Review Group are summarized in Web Annex A.