Symptom‐ and chest‐radiography screening for active pulmonary tuberculosis in HIV‐negative adults and adults with unknown HIV status

Population: of people with HIV‐negative or unknown HIV status who are considered eligible for systematic screening for tuberculosis disease. Role of index test: individuals with a positive screening test are offered further confirmatory testing to establish a tuberculosis diagnosis. Reference standards: any one or combination of mycobacterial culture (on solid or liquid medium), sputum smear microscopy, Xpert MTB/RIF, or other nucleic acid amplification test. Study design: cross‐sectional studies. Cough for two weeks or more summary sensitivity (95% CI): 42.1% (36.6 to 47.7); summary specificity (95% CI): 94.4% (92.6 to 95.8)

Population: of people with HIV‐negative or unknown HIV status who are considered eligible for systematic screening for tuberculosis disease. Role of index test: individuals with a positive screening test are offered further confirmatory testing to establish a tuberculosis diagnosis. Reference standards: any one or combination of mycobacterial culture (on solid or liquid medium), sputum smear microscopy, Xpert MTB/RIF, or other nucleic acid amplification test. Study design: cross‐sectional studies. Cough of any duration summary sensitivity (95% CI): 51.3% (42.8 to 59.7); summary specificity (95% CI): 87.6% (81.6 to 91.8)

Population: of people with HIV‐negative or unknown HIV status who are considered eligible for systematic screening for tuberculosis disease. Role of index test: individuals with a positive screening test are offered further confirmatory testing to establish a tuberculosis diagnosis. Reference standards: any one or combination of mycobacterial culture (on solid or liquid medium), sputum smear microscopy, Xpert MTB/RIF, or other nucleic acid amplification test. Study design: Cross‐sectional studies. Any tuberculosis symptom summary sensitivity (95% CI): 70.6% (61.7 to 78.2); summary specificity (95% CI): 65.1% (53.3 to 75.4)

Population: of people with HIV‐negative or unknown HIV status who are considered eligible for systematic screening for tuberculosis disease. Role of index test: individuals with a positive screening test are offered further confirmatory testing to establish a tuberculosis diagnosis. Reference standards: any one or combination of mycobacterial culture (on solid or liquid medium), sputum smear microscopy, Xpert MTB/RIF, or other nucleic acid amplification test. Study design: cross‐sectional studies. Any CXR abnormality summary sensitivity (95% CI): 94.7% (92.2 to 96.4); summary specificity (95% CI): 89.1% (85.6 to 91.8)

Population: of people with HIV‐negative or unknown HIV status who are considered eligible for systematic screening for tuberculosis disease. Role of index test: individuals with a positive screening test are offered further confirmatory testing to establish a tuberculosis diagnosis. Reference standards: any one or combination of mycobacterial culture (on solid or liquid medium), sputum smear microscopy, Xpert MTB/RIF, or other nucleic acid amplification test. Study design: cross‐sectional studies. CXR abnormalities suggestive of tuberculosis summary sensitivity (95% CI): 84.8% (76.7 to 90.4); summary specificity (95% CI): 95.6% (92.6 to 97.4)