Rev. ed. of: Assessing tuberculosis prevalence through population-based surveys. 2007.

This publication provides countries with practical guidelines for planning population-based surveys to estimate the prevalence of tuberculosis (TB) at a national level. TB prevalence surveys yield useful information in areas where notification data obtained through routine surveillance are incomplete, or of unproven accuracy, and in areas with an estimated TB prevalence of more than 100 per 100 000. These surveys are used to evaluate the performance of the TB program, and to assess trends over time. To achieve this objective, data are collected through standards methods in a well-defined study population. This document is meant to provide information on the core survey methods, including diagnostic tests for TB, screening strategies, and case definitions. The target audience includes TB experts and advisers at national and international levels, and investigators involved in prevalence surveys.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.

Current data and trends in morbidity and mortality for the sub-Saharan Region as presented in this new edition reflect the heavy toll that HIV/AIDS has had on health indicators, leading to either a stalling or reversal of the gains made, not just for communicable disorders, but for cancers, as well as mental and neurological disorders.

The WHO consolidated guidelines on tuberculosis. Module 2: screening – systematic screening for tuberculosis disease is an updated and consolidated summary of WHO recommendations on systematic screening for tuberculosis (TB) disease, containing 17 recommendations for populations in which TB screening should be conducted and tools to be used for TB screening. TB screening is strongly recommendations for household and close contacts of individuals with TB, people living with HIV, miners exposed to silica dust, and prisoners. In addition, screening is conditionally recommended for people with risk factors for TB attending health care, and for communities with risk factors for TB and limited access to care (e.g. homeless, urban poor, refugees, migrants). General population screening is recommended in high-burden settings (0.5% prevalence or higher). Symptoms, chest radiography (CXR), and molecular WHO-recommended rapid diagnostic tests for TB are recommended as screening tools for all adults eligible for screening. Computer-aided detection programmes are recommended as alternatives to human interpretation of CXR in settings where trained personnel are scarce. For people living with HIV, C-reactive protein is also a good screening tool. This guideline document is accompanied by an operational handbook, the WHO operational handbook on tuberculosis. Module 2: screening – systematic screening for tuberculosis disease, that presents principles of screening, steps in planning and implementing a screening programme, and algorithm options for screening different populations.

There have been calls to revisit the experiences of TB screening campaigns that were widely applied in Europe and North America in the mid-20th century, as well as more recent experiences with TB screening in countries with a high burden of the disease, and to assess their possible relevance for TB care and prevention in the 21st century. In response, WHO has developed guidelines on screening for active TB. An extensive review of the evidence has been undertaken. The review suggests that screening, if done in the right way and targeting the right people, may reduce suffering and death, but the review also highlights several reasons to be cautious. As discussed in detail in this book, there is a need to balance potential benefits against the risks and costs of screening; this conclusion is mirrored by the history of TB screening. This publication presents the first comprehensive assessment by WHO of the appropriateness of screening for active TB since the recommendations made in 1974 by the Expert Committee. However, the relative effectiveness and cost effectiveness of screening remain uncertain, a point that is underscored by the systematic reviews presented in this guideline. Evidence suggests that some risk groups should always be screened, whereas the prioritization of other risk groups as well as the choice of screening approach depend on the epidemiology, the health-system context, and the resources available. This book sets out basic principles for prioritizing risk groups and choosing a screening approach; it also emphasizes the importance of assessing the epidemiological situation, adapting approaches to local situations, integrating TB screening into other health-promotion activities, minimizing the risk of harm to individuals, and engaging in continual monitoring and evaluation. It calls for more and better research to assess the impact of screening and to develop and evaluate new screening tests and approaches.

Before effective treatments were introduced in the 1950s, tuberculosis was a leading cause of death and disability in the United States. Health care workers were at particular risk. Although the occupational risk of tuberculosis has been declining in recent years, this new book from the Institute of Medicine concludes that vigilance in tuberculosis control is still needed in workplaces and communities. Tuberculosis in the Workplace reviews evidence about the effectiveness of control measuresâ€"such as those recommended by the Centers for Disease Control and Preventionâ€"intended to prevent transmission of tuberculosis in health care and other workplaces. It discusses whether proposed regulations from the Occupational Safety and Health Administration would likely increase or sustain compliance with effective control measures and would allow adequate flexibility to adapt measures to the degree of risk facing workers.