Pulmonary tuberculosis

The US Centers for Disease Control and Prevention and the US Preventive Services Task Force recommend that asymptomatic adults at increased risk of infection in the US are screened for latent infection, including persons born in or former residents of countries with high TB prevalence, current or former residents of high-risk congregate settings, people living with HIV, intravenous drug users, and contacts of individuals with pulmonary TB.[31]Centers for Disease Control and Prevention (CDC). Updated guidelines for the use of nucleic acid amplification tests in the diagnosis of tuberculosis. MMWR Morb Mortal Wkly Rep. 2009 Jan 16;58(1):7-10. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5801a3.htm http://www.ncbi.nlm.nih.gov/pubmed/19145221?tool=bestpractice.com [60]U.S. Preventive Services Task Force. Latent tuberculosis infection in adults: screening. May 2023 [internet publication]. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/latent-tuberculosis-infection-screening ​​ Healthcare workers should be tested for latent infection if a TB exposure has occurred.[61]Sosa LE, Njie GJ, Lobato MN, et al. Tuberculosis screening, testing, and treatment of U.S. health care personnel: recommendations from the National Tuberculosis Controllers Association and CDC, 2019. MMWR Morb Mortal Wkly Rep. 2019 May 17;68(19):439-43. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522077 http://www.ncbi.nlm.nih.gov/pubmed/31099768?tool=bestpractice.com A tuberculin skin test or interferon gamma release assay are the standard method for identifying persons infected with the mycobacterium.[31]Centers for Disease Control and Prevention (CDC). Updated guidelines for the use of nucleic acid amplification tests in the diagnosis of tuberculosis. MMWR Morb Mortal Wkly Rep. 2009 Jan 16;58(1):7-10. https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5801a3.htm http://www.ncbi.nlm.nih.gov/pubmed/19145221?tool=bestpractice.com Screening persons other than high-risk population places a burden on resources and is therefore not recommended. Cochrane reviews of screening in children and in adults found that screening tests using symptoms or chest x-ray may be useful; however, better screening tests for tuberculosis are needed.[62]Vonasek B, Ness T, Takwoingi Y, et al. Screening tests for active pulmonary tuberculosis in children. Cochrane Database Syst Rev. 2021 Jun 28;6:CD013693. https://www.doi.org/10.1002/14651858.CD013693.pub2 http://www.ncbi.nlm.nih.gov/pubmed/34180536?tool=bestpractice.com [63]Van't Hoog A, Viney K, Biermann O, et al. Symptom- and chest-radiography screening for active pulmonary tuberculosis in HIV-negative adults and adults with unknown HIV status. Cochrane Database Syst Rev. 2022 Mar 23;3:CD010890. https://www.doi.org/10.1002/14651858.CD010890.pub2 http://www.ncbi.nlm.nih.gov/pubmed/35320584?tool=bestpractice.com

Screening is only one aspect of controlling the disease; it is recommended that priority should be given to completion of treatment of active disease and investigating contacts.