Early detection of the most infectious patients (those with sputum smear-positive PTB) should be a priority, so that these patients can be treated before infecting others. Early detection and treatment of these cases also speeds recovery and limits the lung destruction. This section will cover the following ISTC standards and tasks to which all physicians should adhere:

• Recognize individual and group risk factors for TB and perform prompt clinical evaluations for those people with signs and symptoms. (Standard 1)


• Identify people with suspected TB by asking all adults about cough. If an adult has an otherwise unexplained productive cough for 2 weeks or more or chest radiographs consistent with TB, suspect possible PTB. (Standard 2)


• Ensure collection of two high quality sputum specimens for smear microscopy or culture, or one sample for Xpert MTB/RIF for adults and children with suspected pulmonary TB. Serologic tests should not be used for diagnosing active disease.(Standard 3)