ArticleIJTLD open2026
Start4All: protocol for evaluating TB screening and diagnostic tests and test algorithms in the community and lower care levels in seven high-burden countries.
Article in IJTLD open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite advances in TB care, approximately 2.4 million people with TB remain undiagnosed or unreported each year. A key contributor to these 'missed millions' is that major diagnostic gaps persist especially among underserved populations. Developing diagnostic algorithms that are accessible and integrated into health care systems where they are intended to be used is essential to meet WHO End TB targets.
methodsStart4All a multi-country, cross-sectional diagnostic accuracy study (in Bangladesh, Brazil, Cameroon, Kenya, Malawi, Nigeria, and Viet Nam) aims to assess and model algorithms using combinations of WHO-endorsed, and experimental TB screening and diagnostic tests across the lowest levels of care and the community, compared to a sputum culture reference standard. Evaluated tools include C-reactive protein tests, computer-aided detection-interpreted chest X-rays, pooled Xpert® MTB/RIF Ultra (Xpert Ultra) testing, and a third generation lipoarabinomannan (LF-LAM) assay. DISCUSSION: Start4All will generate high-quality evidence to guide policy decisions on the adoption and the integration of non-sputum and laboratory independent tools to accelerate early TB detection and close the treatment gap.
conclusionA feature of Start4All is its implementation within national TB programmes across seven high-burden countries to ensure that findings are directly translatable to policy and operational decision making. Harmonised protocols, standardised microbiological reference testing, and unified data management systems will enable cross-country comparison and strengthen the external validity of results.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.