ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
The Spectrum of Tuberculosis Disease in an Urban Ugandan Community and Its Health Facilities.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 2 of them syntheses that pooled it.
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Who cites it
45 citing papers in PubMed, 2 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Xpert MTB/RIF Ultra assay for pulmonary tuberculosis and rifampicin resistance in adults and adolescents.The Cochrane database of systematic reviews · 2025Pooled it
- Subclinical tuberculosis: a meta-analysis of prevalence and scoping review of definitions, prevalence and clinical characteristics.European respiratory review : an official journal of the European Respiratory Society · 2024Pooled it
- Community-based chest X-ray screening versus symptom-based case presentation in the elderly: evidence from three consecutive years of data.BMC geriatrics · 2026Article
- Tuberculosis in households with infectious cases in Kampala city: Harnessing health data science for new insights on an ancient disease with persistent, unresolved problems (DS-IAFRICA-TB) Study Protocol.medRxiv : the preprint server for health sciences · 2026Article
- Trade-offs in diagnostic algorithm, population coverage, and duration of community screening for tuberculosis: A modelling study.PLoS medicine · 2026Article
- Article
- Whom tuberculosis tests detect and why it matters: implications for diagnostic algorithms.The Lancet. Microbe · 2025Review
- Screening for asymptomatic tuberculosis among adults with household exposure to pulmonary tuberculosis: a prospective observational cohort study.The Lancet. Global health · 2025Observational
- Importance of confirmatory test characteristics in optimizing community-based screening for tuberculosis: an epidemiological modeling analysis.BMC infectious diseases · 2025Article
- The potential yield of geographically targeted tuberculosis contact investigation in urban Uganda.Epidemiology and infection · 2025Article
- Do no harm - re-evaluating the risks of overtreatment in community-wide tuberculosis screening.medRxiv : the preprint server for health sciences · 2025Article
- Mind the Clinic-Community Gap: Re-evaluation of Test Performance and False Positive Results in Community-Wide Tuberculosis Screening.The Journal of infectious diseases · 2025Article
- The relationship between a known diagnosis of tuberculosis and symptom reporting: implications for case detection strategies.The European respiratory journal · 2025Article
- Pulmonary Tuberculosis Infectiousness of Persons Identified Through Active and Passive Case-finding in a High-burden Setting.Open forum infectious diseases · 2025Article
- Mobility patterns, activity locations, and TB in Nairobi, Kenya.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2025Article
- Active search for tuberculosis in three youth detention centers in Peru.Revista peruana de medicina experimental y salud publica · 2025Article
- Potential impact, costs, and benefits of population-wide screening interventions for tuberculosis in Viet Nam: A mathematical modelling study.PLOS global public health · 2025Article
- Non-additive strong gene interactions cause striking differences in organ pathology and cytokine response in Leishmaniasis.Frontiers in immunology · 2025Article
- Article
- Comprehensive Tuberculosis Screening and Treatment at a Prison in Central Papua Province, Indonesia.Tropical medicine and infectious disease · 2024Article
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Authors and funding
13 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundNew, sensitive diagnostic tests facilitate identification and investigation of milder forms of tuberculosis (TB) disease. We used community-based TB testing with the Xpert MTB/RIF Ultra assay ("Ultra") to characterize individuals with previously undiagnosed TB and compare them to those from the same community who were diagnosed with TB through routine care.
methodsWe offered community-based sputum Ultra testing to adult residents of a well-defined area (population 34 000 adults) in Kampala, Uganda, via door-to-door screening and venue-based testing, then used detailed interview and laboratory testing to characterize TB-positive individuals. We compared these individuals to residents diagnosed with pulmonary TB at local health facilities and a representative sample of residents without TB (controls).
resultsOf 12 032 residents with interpretable Ultra results, 113 (940 [95% confidence interval {CI}, 780-1130] per 100 000) tested positive, including 71 (63%) positive at the lowest (trace) level. A spectrum of TB disease was observed in terms of chronic cough (93% among health facility-diagnosed cases, 77% among residents with positive community-based Ultra results at levels above trace, 33% among trace-positive community participants, and 18% among TB-negative controls), TB symptom prevalence (99%, 87%, 60%, and 38%, respectively), and C-reactive protein (75th percentile: 101 mg/L, 28 mg/L, 6 mg/L, and 4 mg/L, respectively). Community-diagnosed cases were less likely than health facility-diagnosed cases to have human immunodeficiency virus coinfection or previous TB. The specificity of Ultra was 99.4% (95% CI, 99.2%-99.5%) relative to a single spot sputum culture.
conclusionsPeople with undiagnosed prevalent TB in the community have different characteristics than those diagnosed with pulmonary TB in health facilities. Newer diagnostic tests may identify a group of people with early or very mild disease.
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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 OpenQuestion graph.