What if They Don't Have Tuberculosis? The Consequences and Trade-offs Involved in False-positive Diagnoses of Tuberculosis

Rein M.G.J. Houben, Marek Lalli, Katharina Kranzer, Nick A. Menzies, Samuel G. Schumacher, David Wesley Dowdy

Research output: Contribution to journalArticle

Abstract

To find the millions of missed tuberculosis (TB) cases, national TB programs are under pressure to expand TB disease screening and to target populations with lower disease prevalence. Together with imperfect performance and application of existing diagnostic tools, including empirical diagnosis, broader screening risks placing individuals without TB on prolonged treatment. These false-positive diagnoses have profound consequences for TB patients and prevention efforts, yet are usually overlooked in policy decision making. In this article we describe the pathways to a false-positive TB diagnosis, including trade-offs involved in the development and application of diagnostic algorithms. We then consider the wide range of potential consequences for individuals, households, health systems, and reliability of surveillance data. Finally, we suggest practical steps that the TB community can take to reduce the frequency and potential harms of false-positive TB diagnosis and to more explicitly assess the trade-offs involved in the screening and diagnostic process.

Original languageEnglish (US)
Pages (from-to)150-156
Number of pages7
JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Volume68
Issue number1
DOIs
StatePublished - Jan 1 2019

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Tuberculosis
Health Services Needs and Demand
Policy Making
Decision Making
Pressure
Health

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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What if They Don't Have Tuberculosis? The Consequences and Trade-offs Involved in False-positive Diagnoses of Tuberculosis. / Houben, Rein M.G.J.; Lalli, Marek; Kranzer, Katharina; Menzies, Nick A.; Schumacher, Samuel G.; Dowdy, David Wesley.

In: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Vol. 68, No. 1, 01.01.2019, p. 150-156.

Research output: Contribution to journalArticle

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