![]() ![]() There is no ideal universal algorithm exist in primary care nonetheless, the solution could be a screening test followed by one confirmatory test or one screening test followed by two sequential confirmatory tests or two parallel screening test followed by one confirmatory test or two subsequent screening test followed by one confirmatory test. The sensitivity and specificity analysis depend on many factors such as the presence of HIV status, the age of the patient, the disease severity, background epidemiology, sputum processing and staining techniques, and diagnostic quality. Whereas, the sensitivity and specificity of the two confirmatory tests are 61%, 98% in SSM, respectively though it is higher in XP reaches to 90%, 99% respectively. The sensitivity and specificity of symptoms inquiry screening questionnaire are 77%, 66% respectively, while it is better in PPD 89%, 80% respectively though it is higher in CXR reaches to 86%, 89% respectively. Any patients who do not respond after a short course of broad-spectrum antibiotics should be re-assessed for hidden TB. Nonetheless, most clinician's judgment to reach a diagnosis of active TB is from symptoms inquiry questionnaire and chest radiography findings. The common two confirmatory tests of active TB are sputum-smear microscopy (SSM) and Xpert MTB/RIF (XP). The sensitivity of symptoms inquiry and CXR is better than other methods, and it has mirrors for any CXR abnormality' in symptomatic persons. The conventional three screening tests of TB are symptoms inquiry questionnaire by asking about the existence of prolonged productive cough, haemoptysis, night fever, night sweating, weight loss, and pleuritic chest pain, besides chest x-ray (CXR) and PPD screening test. ![]() The best method for TB screening is both symptom inquiry and chest radiograph (CXR), which depends on resource availability, cost and the expected yield. TB screening is the process of system identification for apparently healthy people with suspected active TB by using tests, examinations, or other procedures which should be applied to risky groups. Setting a nationally standardized TB screening program is essential in the early detection of active pulmonary TB in Bahrain and training all Primary Care Physicians (PCPs) is vital for early detection of active TB cases. TB screening programme, Confirmatory test of TB, Radiological finding of TB, Sensitivity and specificity of TB screening tests The essential keys are to teach and train all physicians in the detection of early symptoms with x-ray findings of active, inactive and diagnose latent pulmonary tuberculosis. The Bahrain screening program depends primarly on the use of chest x-ray and PPD, while not using both symptom inquiry and Xpert MTB/RIF (XP). ![]()
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