The World Health Organization (WHO) has published updated Target product profiles (TPPs) for tuberculosis (TB) screening tests. This follows the recent publication of a TPP for serious bacterial infection among young infants, including neonatal sepsis, covered in last week’s newsletter.
These TPPs define the most important characteristics and requirements to be considered in the development of new tests for systematic screening for TB and active TB case finding.
In 2014, WHO published its first TPPs for tests to improve the early detection of TB, with the intent to spur the development of novel tools that could detect more people with TB whose diagnosis would otherwise be missed or delayed.
In the decade since the first TPPs were released, there have been significant advancements in screening technology, including portable digital radiographic equipment, alongside innovations driven by artificial intelligence (AI) including computer-aided detection software, which can provide automated interpretation of chest X-rays for TB screening. Despite these advances, important challenges remain in bringing screening to the scale needed to close the case detection gap and reduce the TB burden globally. Foremost among these challenges is the availability of screening tools with a low cost and high accuracy.
The 2025 TPPs provide technology-agnostic guidance encompassing all possible approaches used for screening. Three types of screening tools are defined, that may be effective in TB screening in different settings and situations. These updated TPPs were developed after in-depth discussion with global experts for options in novel TB screening tests, informed by modelling of the performance and costs of novel tests.
