New Insights in Screening and Preventive Treatment for Tuberculosis

Dear Colleagues,

This Special Issue of Tropical Medicine and Infectious Diseases focuses on the current state of the science and future possibilities for systematic screening and preventive treatment for tuberculosis (TB). With over 10 million people developing TB disease each year, 40% of whom are not diagnosed or reported, and an estimated one quarter of the world’s population having been infected with Mycobacterium tuberculosis, TB is a significant threat to global health.

To reduce the global burden of TB and to combat the large and persistent TB case detection gap, the WHO currently recommends systematic screening for TB and TB-preventive treatment (TPT) in populations at highest risk for the disease, including close contacts of TB patients, people living with HIV, prisoners, and miners. TB screening is also recommended in other populations at a higher risk of developing TB, including people with clinical risk factors (e.g., malnutrition, lung disease, and immunocompromising conditions) and communities with structural risk factors (e.g., the urban poor, homeless individuals, and refugee communities). Population-wide TB screening is also recommended in very-high-prevalence areas. Screening with chest radiography and computer-aided detection (CAD) are promoted as the most accurate currently available screening approaches.

However, much is still unknown about the optimal approaches for implementing TB screening and TPT, including what tools and algorithms are most effective for scaling up screening and TPT more broadly. Further research is also needed on the impact of screening and TPT on TB epidemiology, including what risk groups and populations are most essential to target with these strategies and what level of coverage is needed to achieve lasting reductions in TB burden.

The WHO’s End TB Strategy includes targets for 2025 of diagnosing and starting on treatment 90% of all people who develop TB each year, and initiating 90% of all eligible people on TPT. In order to achieve these targets, new research on and the scaling up of proven strategies are urgently needed to improve the current approaches to finding people with TB and preventing the disease in those at highest risk.

Dr. Cecily R. Miller
Guest Editor

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• tuberculosis/prevention and control
• contact tracing
• tuberculosis/epidemiology
• tuberculosis/diagnostic imaging
• latent tuberculosis/therapy