ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2022
How "Subclinical" is Subclinical Tuberculosis? An Analysis of National Prevalence Survey Data from Zambia.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 30 citations in OpenAlex.
- 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
- Yield and Efficiency of a Population-Based Mass Tuberculosis Screening Intervention Among Persons With Diabetes in Jiangsu Province, China.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Pooled it
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- Mycobacterium tuberculosis transmission from tuberculosis patients with and without recognized symptoms: a case-contact study in eastern China.Nature communications · 2026Article
- Factors associated with tuberculosis symptom reporting among persons deprived of liberty in Brazil during active case finding: a cross-sectional study.BMJ public health · 2026Article
- Symptomatic (STB) and Asymptomatic (ATB) tuberculosis in Italy: Results from a multicenter retrospective study.Journal of clinical tuberculosis and other mycobacterial diseases · 2025Article
- Article
- Diagnostic accuracy of smear microscopy, mycobacterial culture, and GeneXpert MTB/RIF assay for diagnosis of subclinical tuberculosis: a retrospective multicenter study.Microbiology spectrum · 2025Article
- Prevalence, Progression, and Treatment of Asymptomatic Tuberculosis: A Prospective Cohort Study in Lanxi County, Zhejiang Province, China.Open forum infectious diseases · 2025Article
- The burden of subclinical TB in Nigeria.Public health action · 2024Article
- Classification of early tuberculosis states to guide research for improved care and prevention: an international Delphi consensus exercise.The Lancet. Respiratory medicine · 2024Review
- Public health implications of the evolving understanding of tuberculosis natural history.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2024Article
- Mass Tuberculosis Screening Among the Elderly: A Population-Based Study in a Well-Confined, Rural County in Eastern China.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Association of diabetes, smoking, and alcohol use with subclinical-to-symptomatic spectrum of tuberculosis in 16 countries: an individual participant data meta-analysis of national tuberculosis prevalence surveys.EClinicalMedicine · 2023Article
- Disease Transmission by Patients With Subclinical Tuberculosis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Characteristics of subclinical tuberculosis compared to active symptomatic tuberculosis using nationwide registry cohort in Korea: prospective cohort study.Frontiers in public health · 2023Article
- Time to change the way we think about tuberculosis infection prevention and control in health facilities: insights from recent research.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Prevalence and risk factors of M tuberculosis infection in young people across 14 communities in Zambia and South Africa.PLOS global public health · 2023Article
- Prevalence of subclinical pulmonary tuberculosis and its association with HIV in household contacts of index tuberculosis patients in two South African provinces: a secondary, cross-sectional analysis of a cluster-randomised trial.BMC global and public health · 2023Article
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6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPulmonary tuberculosis infection can manifest in different states, including subclinical tuberculosis. It is commonly defined as confirmed tuberculosis without the classic symptoms (commonly, persistent cough for ≥2 weeks). This narrow definition likely poses limitations for surveillance and control measures. The aims of the current study were to characterize the clinical presentation of tuberculosis; estimate the prevalence of subclinical tuberculosis among individuals with bacteriologically confirmed tuberculosis, using various definitions; and investigate risk factors for subclinical as opposed to clinical tuberculosis in a population-based survey.
methodsWe conducted a secondary analysis of data from a nationally representative tuberculosis prevalence survey from Zambia in 2013-2014, in which participants were screened for tuberculosis based on chest radiographic findings and symptoms. Tuberculosis was defined as culture-positive or GeneXpert MTB/RIF test-positive sputum. Risk factors for subclinical tuberculosis were assessed by means of multivariable logistic regression.
resultsOf 257 participants with confirmed tuberculosis, 104 (40.5%) were without cough persisting ≥2 weeks. Only 23 (22.1%) of these did not present with any other common symptoms. Those without cough persisting ≥2 weeks frequently reported other symptoms, particularly chest pain (46.2%) and weight loss (38.5%); 36 (34.6%) reported experiencing other symptoms persisting ≥4 weeks. Female subjects were more likely to report no cough persisting ≥2 weeks, as were relatively wealthier individuals.
conclusionsThe commonly used definition of subclinical tuberculosis includes a large proportion of individuals who have other tuberculosis-suggestive symptoms. Requiring cough ≥2 weeks for tuberculosis diagnosis likely misses many active tuberculosis infections and allows a large reservoir of likely transmissible tuberculosis to remain undetected.
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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.