Scaling-up symptom-agnostic, community-wide screening toward global tuberculosis elimination: opportunities, challenges, and lessons from history
- Author(s)
- Esmail, H; Miller, C; Falzon, D; de Vries, G; Chijioke-Akaniro, O; Horton, KC; Kohli, M; Dharmapuri Vachaspathi, T; Vo, LNQ; Zaidi, SMA; Squire, SB; Coussens, AK; Houben, Rmgj;
- Journal Title
- International Journal of Infectious Diseases
- Abstract
- There has been little change in global tuberculosis (TB) incidence in the 21(st) century. Although case notification has increased, millions of people with TB each year remain unreached. Recently there has been increased recognition that many people with undiagnosed, potentially infectious TB do not experience or report TB symptoms. Symptom-agnostic screening (e.g., by chest X-ray) can effectively identify such forms of TB. Although this activity is increasing globally and is beneficial to individuals screened, current levels fall far short of what is needed to impact transmission and population-level prevalence. A significant scale-up of symptom-agnostic screening across communities is required to improve treatment coverage and interrupt transmission. Although there are major political, financial, and health system challenges to undertaking such scale-up this is not without precedent. In the mid-20(th) century, in many countries that now experience a low TB burden, population-level chest X-ray screening was successfully undertaken and contributed to the decline in TB. In this article, we explore the challenges and opportunities that face countries wanting to scale-up symptom-agnostic screening and reflect on important lessons from the past.
- Publisher
- Elsevier
- Keywords
- Humans; *Mass Screening/methods/history; *Tuberculosis/diagnosis/epidemiology/prevention & control; Global Health; *Disease Eradication; History, 20th Century; History, 21st Century; Prevalence; Incidence; Asymptomatic; Chest X-ray; Screening; Symptom-agnostic; Tuberculosis
- Research Division(s)
- Infection and Global Health
- PubMed ID
- 40068708
- Publisher's Version
- https://doi.org/10.1016/j.ijid.2025.107875
- Open Access at Publisher's Site
https://doi.org/ 10.1016/j.ijid.2025.107875- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2025-05-29 02:28:58
Last Modified: 2025-05-29 02:34:19