USPSTF: Screen All At-Risk Adults for Latent Tuberculosis

The US Preventive Services Task Force (USPSTF) has issued a grade B recommendation that asymptomatic adults at increased risk of developing latent tuberculosis (LTB) should be screened for the condition.

The recommendation updates the USPSTF’s 1996 grade A recommendation to screen high-risk adults with the tuberculin skin test.

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“Tuberculosis remains an important preventable disease in the United States,” the authors wrote. “An effective strategy for reducing the transmission, morbidity, and mortality of active disease is the identification and treatment of latent tuberculosis infection to prevent progression to active disease.”

After reviewing available evidence on the screening for LTB among asymptomatic adults in the primary care setting, the USPSTF found “adequate evidence” that accurate screening tests for LTB are available, that treatment of LTB provides a moderate health benefit in preventing progression to active disease, and that the harms of screening are minimal.

Those at high risk including individuals born in, or who had previously lived in, regions with increased risk of TB, and adults living in settings including homeless shelters and prisons. Screening frequency is dependent on the individuals’ level of risk.

The USPSTF identified several areas in need of further research, including an evaluation of risk assessment tools, additional research on how often LTB screening should be conducted in various subpopulations, and studies to clarify whether certain screening methods are more suitable in certain risk groups.

—Michael Potts

Reference:

US Preventive Services Task Force. Screening for latent tuberculosis infection in adults: US Preventive Services Task Force recommendation statement. JAMA. 2016;316(9):962-969.