Screening for Latent Tuberculosis Infection in Adults: US Preventive Services Task Force Recommendation Statement

Area of Science:

• Public Health
• Preventive Medicine
• Infectious Disease Epidemiology

Background:

• Tuberculosis (TB) remains a significant preventable disease in the US, encompassing both infectious active TB and asymptomatic latent TB infection (LTBI).
• LTBI, estimated to affect up to 13 million Americans, can progress to active disease, highlighting the need for effective screening and management strategies.
• TB incidence is influenced by social determinants of health, underscoring geographic and accommodation-related disparities.

Purpose of the Study:

• To update the 2016 recommendation on screening and treatment for LTBI.
• To evaluate the accuracy of LTBI screening tests in asymptomatic adults.
• To provide evidence-based guidance for primary care settings.

Main Methods:

• A systematic review was commissioned by the US Preventive Services Task Force (USPSTF).
• The review focused on screening and treatment of LTBI in asymptomatic adults at increased risk.
• Accuracy of LTBI screening tests was a key component of the review.

Main Results:

• Screening for LTBI in individuals at increased risk demonstrates a moderate net benefit in preventing active tuberculosis.
• The USPSTF found moderate certainty supporting this conclusion.
• The findings are applicable to asymptomatic adults aged 18 and older.

Conclusions:

• The USPSTF recommends screening for latent tuberculosis infection (LTBI) in populations at increased risk.
• This recommendation (rated B) aims to prevent the progression to active tuberculosis disease.
• Screening is a valuable tool in the primary care management of tuberculosis prevention.