WHO consolidated guidelines on tuberculosis: module 3: diagnosis: tests for TB infection: web annex C: GRADE profiles of Mycobacterium tuberculosis antigen-based skin tests

This web annex to the WHO consolidated guidelines on tuberculosis, Module 3: diagnosis, presents GRADE evidence profiles for Mycobacterium tuberculosis antigen-based skin tests (TBSTs) used for the diagnosis of tuberculosis infection. The document summarizes evidence on the diagnostic accuracy, specificity, concordance and safety of TBSTs in comparison with tuberculin skin tests (TSTs) and interferon-gamma release assays (IGRAs). It includes analyses for populations at high risk of tuberculosis infection, children, Bacillus Calmette-Guérin (BCG)-vaccinated individuals and people living with HIV.

The annex provides evidence tables describing study designs, certainty assessments, prevalence estimates and diagnostic performance outcomes, including sensitivity, specificity, concordance and adverse reactions. It also outlines factors influencing certainty of evidence, such as risk of bias, inconsistency and imprecision. By compiling the evidence underpinning WHO recommendations, the publication supports transparency in guideline development and informs the evaluation of antigen-based skin tests for tuberculosis infection testing in different epidemiological and clinical settings.