30 Apr Doctoral study identifies TB screening strategy significantly improving detection
Research completed under AIGHD supervision demonstrates that simultaneously screening for both active and dormant TB infection could save lives and curtail infection rates, especially among migrants from TB high burden countries.
Dr Dominik Zenner conducted the study with a team of researchers as part of his University of Amsterdam PhD. Supervised by AIGHD Senior Fellow Prof Frank Cobelens, Dr Zenner’s degree was conferred in October 2024. Thought preventable and curable, TB continues killing 1.5 million people each year – making it the world’s top infectious killer.
After analysing the efficacy of combinations of commonly used tests for TB, Dr Zenner and his team proposed that some immunological tests for dormant TB infection (TBI tests) be included in TB screening algorithms. TBI tests could also support earlier diagnosis of harder to detect TB, including extrapulmonary TB (disease that occurs outside the patient’s lungs), or TB in children.
The study examined data on 13 different TB tests, described in 437 original studies and published systematic reviews. The data were then used to estimate how well screening tests correctly identified TB and avoided false positive results.
Published in the European Respiratory Journal, the researchers hope their study will inform guidance from global health organisations and key decision-makers on the most effective way to screen for TB.
‘Major implications’ for policy change
“Global TB control requires early identification and treatment of TB in risk groups,” said Dr Zenner. “Our novel screening algorithms show that screening for active and dormant TB can be done simultaneously with high accuracy for migrants from countries where TB is common to improve individual and population benefits.”
The former director of the Global Programme on Tuberculosis & Lung Health at the World Health Organization and currently professor of global health at the University of Milan, Mario Raviglione, said: “This is a very sophisticated and well-thought study with major implications for clinical and public health practice, as well as policy change.
“By reviewing sound evidence and applying modern statistical methods, the authors have concluded that adopting an Interferon Gamma Release Assay (IGRA) test – a blood test that detects the response of white blood tests to TB antigens – on top of more traditional TB screening methods, the accuracy of screening migrants for active TB increases significantly.”
This report was adapted from a news release by the Queen Mary University of London’s Wolfson Institute of Population Health.
Main picture: Dr Dominik Zenner receives his doctoral degree from Prof Ibrahim Abubakar of University College London, the second promotor of Dr Zenner’s PhD with AIGHD Senior Fellow Prof Frank Cobelens.