Could Screening for Both Active and Dormant TB Infections Improve Detection?

Screening individuals for both active and dormant tuberculosis (TB) infections simultaneously could significantly enhance early detection and improve patient outcomes, according to a new study led by researchers at Queen Mary University of London (1^✔ ✔Trusted Source
How to diagnose TB in migrants? A systematic review of reviews and decision tree analytical modelling exercise to evaluate properties for single and combined TB screening tests

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Innovative TB Screening Strategy

The research team’s innovative approach offers a solution to the limitations of current TB screening methods, which often struggle to detect the disease accurately. Published in the European Respiratory Journal, the findings suggest that integrating tests for both active and latent TB infections could help reduce infection rates and save lives, especially among high-risk groups.

“Global TB control depends heavily on the early identification and treatment of TB in vulnerable populations. Our new screening algorithms show that it is possible to screen for both active and dormant TB infections with high accuracy, particularly among migrants from TB-endemic countries,” said Dr. Dominik Zenner, Clinical Reader in Infectious Disease Epidemiology at Queen Mary.

The researchers emphasized that TB remains one of the world's deadliest infectious diseases, with 10.8 million new cases and 1.25 million deaths recorded globally in 2023. While TB can stay dormant in the body for years without causing symptoms, it may reactivate later, particularly in individuals with weakened immune systems or other risk factors.

Recognizing the need for more comprehensive screening, the team analyzed data from 437 studies and systematic reviews covering 13 different TB tests. Their evaluation focused on the tests’ ability to correctly identify TB cases while minimizing false positives.

The study found that incorporating immunological tests for latent TB infections (known as TBI tests) added significant value to TB detection protocols. Moreover, TBI tests could facilitate earlier diagnosis of challenging TB cases, such as extrapulmonary TB—which affects parts of the body outside the lungs—and TB in children.

This new approach marks a shift from traditional TB testing protocols, which typically use TBI tests only for diagnosing latent infections. Researchers hope that their findings will influence global health guidelines and inform policymakers on the best practices for TB screening.

“By expanding the scope of TB screening to cover both active and latent infections, we can improve detection rates and ultimately enhance the effectiveness of global TB control efforts,” the study concluded.

The researchers advocate for the adoption of this dual-testing method as part of broader strategies to combat TB, particularly in vulnerable and migrant populations, where early detection can make a critical difference.

Reference:

1. How to diagnose TB in migrants? A systematic review of reviews and decision tree analytical modelling exercise to evaluate properties for single and combined TB screening tests - (https://publications.ersnet.org/content/erj/early/2025/04/03/1399300302000-2024)

Source-Medindia