From Tuberculosis › Chapter 6: Screening for active tuberculosis · Médecins Sans Frontières, Current online edition
Introductory section on systematic screening for active TB to improve case detection in high-risk groups.
- Issuer
- Médecins Sans Frontières
- Edition
- Current online edition
- Audience
- Clinicians and public health professionals working in TB programmes
- Reviewed
- 22 Oct 2026 · GMJ
What this guideline says
GMJ summary
This introductory section of the MSF tuberculosis screening chapter emphasises that globally up to 30% of people with tuberculosis remain undetected and untreated. Screening for active TB (also termed ‘intensive case finding for TB’) aims to improve case detection by identifying individuals within high-risk groups—such as contacts of TB patients and HIV-infected persons—who should undergo diagnostic testing.
Early identification through screening enables early diagnosis and treatment, improving treatment outcomes and reducing TB transmission. Screening also identifies individuals who may benefit from latent TB infection (LTBI) diagnosis and treatment. However, screening should only be undertaken when adequate capacity for TB diagnosis and treatment is available.
Key points
For clinicians — doses and thresholds as stated in the guideline
- Up to 30% of people with tuberculosis globally are estimated to be undetected and untreated
- Screening for active TB (intensive case finding) aims to improve case detection in high-risk groups
- High-risk groups include contacts of persons with TB and HIV-infected persons
- Screening enables early diagnosis and treatment, improving outcomes and reducing transmission
- Screening identifies individuals who may benefit from latent TB infection (LTBI) diagnosis and treatment
- Active TB screening should only be undertaken when adequate capacity for diagnosis and treatment exists
From the guideline
Verbatim
“Screening for active TB should be undertaken only if adequate capacity is available for the diagnosis and treatment of active TB.”
Editor’s perspective
Why this matters for Georgia and the region
Prof. Giorgi Pkhakadze, MD, MPH, PhD
Editor-in-Chief, Georgian Medical Journal · Chair, Public Health Institute of Georgia · WHO consultant, health and migration
As Chair of the Public Health Institute of Georgia and WHO consultant on health and migration, I recognise that systematic TB screening in high-risk populations is essential for Georgia, where migration, HIV co-infection and drug-resistant TB continue to challenge our national programme. MSF's emphasis on screening only when diagnostic and treatment capacity exists is the critical caveat: screening without follow-through wastes resources and erodes patient trust. Georgian clinicians should prioritise screening among household contacts of TB patients and people living with HIV, groups we can realistically support with our current GeneXpert network and treatment programmes. The honest acknowledgement that 30% of TB cases remain undetected globally underscores why we must invest not only in screening algorithms but in the laboratory, clinical and public health infrastructure required to act on positive findings.
ORCID 0000-0001-7609-4515 · Perspective written for the GMJ Guidelines Library, 22 Oct 2026
Applicability
Georgia and the South Caucasus
In Georgia and the Eastern Europe/Caucasus region, where TB incidence remains elevated and HIV/TB co-infection poses ongoing challenges, systematic screening in high-risk groups is critical. National TB programmes should ensure that screening initiatives are matched by diagnostic and treatment capacity, including access to GeneXpert and drug susceptibility testing. Given migration patterns between Georgia, Armenia, Azerbaijan and neighbouring countries, cross-border screening strategies for high-risk populations warrant consideration within regional TB control frameworks.
Questions this guideline answers
Quick answers
What is the purpose of screening for active TB?
To improve case detection by identifying individuals within high-risk groups who should undergo TB diagnostic testing, allowing for early diagnosis and treatment.
Who should be screened for active TB?
Individuals within groups at high risk of TB, such as contacts of persons with TB and HIV-infected persons.
What are the benefits of TB screening?
Early diagnosis and treatment, improved treatment outcomes, reduced TB transmission, and identification of people who may benefit from latent TB infection diagnosis and treatment.
What is required before starting TB screening?
Adequate capacity must be available for the diagnosis and treatment of active TB before screening is undertaken.
Related on GMJ
Interconnected resources
Dictionary of Public Health
Conditions A–Z
GMJ News coverage
Quality & accreditation
Same guideline
- Guidance for using diagnostic algorithm for pulmonary tuberculosis — MSF TuberculosisChapter 5: Diagnostic algorithm for pulmonary tuberculosis in symptomatic adolescents and adults
- Diagnostic approach — MSF TuberculosisChapter 4: Diagnosis of active tuberculosis in children
- Diagnosis of Active Tuberculosis in Children: Introduction — MSF TuberculosisChapter 4: Diagnosis of active tuberculosis in children
- Other investigations — MSF TuberculosisChapter 3: Diagnosis and follow-up investigations
- Latent tuberculosis infection — MSF TuberculosisChapter 3: Diagnosis and follow-up investigations
- Active tuberculosis — MSF TuberculosisChapter 3: Diagnosis and follow-up investigations
Other guidelines on this topic
- Guidance for using diagnostic algorithm for pulmonary tuberculosis — MSF Tuberculosis
- Diagnostic approach — MSF Tuberculosis
- Diagnosis of Active Tuberculosis in Children: Introduction — MSF Tuberculosis
- Major genital infections (summary) — Clinical guidelines — Diagnosis and treatment manual — MSF Clinical guidelines
- Venereal warts — MSF Clinical guidelines
- Issuer
- Médecins Sans Frontières
- Guideline
- Tuberculosis
- Chapter
- Chapter 6: Screening for active tuberculosis
- Type
- Clinical guideline (chapter)
- Edition
- Current online edition
- Status
- Current
- Published
- 2026-10-14
- Scope
- Introductory section on screening for active tuberculosis
- Audience
- Clinicians and public health professionals working in TB programmes
- Record history
- Created 22 Oct 2026 · updated 22 Oct 2026 · next check Apr 2027
Médecins Sans Frontières. MSF Tuberculosis: Chapter 6.1 Introduction — Screening for active tuberculosis. In: Tuberculosis [guideline]. Paris: MSF; 2026. Available from: [URL]GMJ Guidelines Library records are original summaries written by the GMJ editorial team from the issuer’s published document and reviewed by a physician. They do not replace the full guideline. The document is the copyright of its issuer and is linked, not hosted. Spotted an error or a newer edition? Tell the Guidelines Desk.
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