Abstract: Tuberculosis remains a major global public health challenge. Current case-finding strategies have obvious shortcomings, with approximately one-fourth of patients not being diagnosed in a timely manner. Active screening can detect early-stage, subclinical patients as well as those not covered by routine medical services. It is a key strategy to achieve the "early detection, early diagnosis, and early treatment" of tuberculosis, and can make up for the deficiency of the current over-reliance on passive detection strategies. Therefore, vigorously promoting active tuberculosis screening has become an important trend in the global Tuberculosis prevention and control field. To facilitate the scientific and effective implementation of active Tuberculosis screening, the authors systematically reviewed the main current technical methods for tuberculosis screening, focused on commenting on the application progress of novel Molecular diagnostic tests in active screening, and discussed their future development directions in combination with screening applications in different scenarios. The authors believe that Molecular diagnostic tests, with their advantages of high sensitivity and specificity, are expected to play a core role in improving detection rates and reducing the disease burden. However, the promotion of these technologies still faces many technical and strategic challenges. In the future, efforts should be made to strengthen the research and development of kits for tuberculosis screening scenarios and non-sputum sample testing, and conduct prospective, multi-center real-world studies for methodological and strategic verification. With the continuous optimization and large-scale application of related technologies, the active tuberculosis screening system will be further improved, and the case-finding capacity is expected to be comprehensively enhanced, which can provide key technical support for the achievement of ending tuberculosis.

Key words: Tuberculosis, Molecular diagnostic tests, Active case-finding, Non-sputum samples