Objective:

To assess the accuracy of tuberculosis (TB) diagnostic strategies for migrant populations and the integration of TB infection tests into screening pathways.

Approach:

• Study Design: Evaluation of 18 TB diagnostic tests across 437 studies, synthesizing data from 32 systematic reviews.
• Metrics Assessed: Focus on test sensitivity, specificity, and diagnostic odds ratios (dORs) to evaluate diagnostic performance.

Key Findings:

• Including interferon gamma release assay (IGRA) tests alongside traditional methods improved screening performance.
• Three-test combinations generally outperformed two-test strategies.
• Tests involving IGRAs as an initial screening step followed by chest X-ray and molecular assays yielded the highest dORs and positive predictive values.
• Parallel symptom/chest X-ray screening followed by molecular confirmation achieved top sensitivity scores.

Interpretation:

Limitations:

• Implementation may depend on local logistics and cost considerations.

Conclusion:

Sources:

• European Respiratory Journal