Risk group screening |
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Systematic screening of high risk populations and prompt access to appropriate treatment are crucial to reduce the TB burden. The WHO guidelines for Systematic Screening for active TB include Chest X-ray as a sensitive screening tool. Stop TB partnership A Paradigm Shift is needed in the way we fight TB “Unless we speak about Active Case Finding, X-ray, contacts, prevention (amongst others) we will not reach our targets”. WHO recommends that priority be given to populations with: ü High TB prevalence (risk factor profile and/or poor access/delay); ü High risk of severe negative consequences if diagnosis is missed; ü High transmission risk.
ACF innovations to support Paradigm Shift implementation
Active case finding in risk groups Previous: symptoms, microscopy & culture: 10-20 days Assuming 3.5% TB prevalence in high risk groups; this could be applicable for high risk populations such as PLWH, diabetics, mine workers, inmates, armed forces, refugee camps with a relatively low number needed to screen in order to diagnose 1 active TB case. Double diagnostic output at same input In below tables the economics of TB screening for 2 algorithms are compared. This cost and yield simulation can be customized in the online model Economics of Screening on this site. Different settings can require other pathways resulting in different economics; costs include depreciation, maintenance, CAD “Pay per use” fee, labor and logistics; assumed Xpert “failed test rate” 10%; daily throughput 100 clients; 1$ = 0.9 €. |