ArticleProceedings of the National Academy of Sciences of the United States of America2022
Infectious and clinical tuberculosis trajectories: Bayesian modeling with case finding implications.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled it.
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Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 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
- Estimating the contribution to transmission of asymptomatic tuberculosis from population-based genomic epidemiology studies.Emerging microbes & infections · 2026Article
- Advanced statistical approaches in tuberculosis diagnosis and treatment outcomes in Africa: a systematic review.Tropical medicine and health · 2026Review
- Comparison of phylogenetic metrics of transmission between symptomatic and asymptomatic tuberculosis in individuals who were incarcerated in Brazil in 2008-24: a retrospective genomic epidemiology study.The Lancet. Microbe · 2026Article
- Inflammatory biomarkers of asymptomatic and symptomatic tuberculosis.Nature communications · 2026Article
- Article
- Transmissibility and Disease Progression of Asymptomatic Mycobacterium tuberculosis Infection, Lima, Peru.Emerging infectious diseases · 2026Article
- A co-evolutionary perspective on humans andeLife · 2026Review
- Mycobacterium tuberculosis biology, pathogenicity and interaction with the host.Nature reviews. Microbiology · 2025Review
- Whom tuberculosis tests detect and why it matters: implications for diagnostic algorithms.The Lancet. Microbe · 2025Review
- Projecting the Impact and Costs of Near Point-of-Care Tuberculosis Screening Assays in Community-based Active Case Finding.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2025Article
- The health impact of identifying a person with tuberculosis through systematic screening.The Lancet. Infectious diseases · 2025Review
- Screening for asymptomatic tuberculosis among adults with household exposure to pulmonary tuberculosis: a prospective observational cohort study.The Lancet. Global health · 2025Observational
- Inflammatory Biomarkers of Asymptomatic and Symptomatic Tuberculosis.bioRxiv : the preprint server for biology · 2025Article
- Importance of confirmatory test characteristics in optimizing community-based screening for tuberculosis: an epidemiological modeling analysis.BMC infectious diseases · 2025Article
- Dysplastic lung repair fosters a tuberculosis-promoting microenvironment through maladaptive macrophage polarization.PLoS pathogens · 2025Article
- Comparison of phylogenetic metrics of transmission in symptomatic and asymptomatic tuberculosis.medRxiv : the preprint server for health sciences · 2025Article
- The relationship between a known diagnosis of tuberculosis and symptom reporting: implications for case detection strategies.The European respiratory journal · 2025Article
- Data-driven targets for reducing the global burden of TB.IJTLD open · 2025Article
- Strategies for shortening tuberculosis therapy.Nature medicine · 2025Review
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
The importance of finding people with undiagnosed tuberculosis (TB) hinges on their future disease trajectories. Assays for systematic screening should be optimized to find those whose TB will contribute most to future transmission or morbidity. In this study, we constructed a mathematical model that tracks the future trajectories of individuals with TB at a cross-sectional timepoint ("baseline"), classifying them by bacterial burden (smear positive/negative) and symptom status (symptomatic/subclinical). We used Bayesian methods to calibrate this model to targets derived from historical survival data and notification, mortality, and prevalence data from five countries. We combined resulting disease trajectories with evidence on infectiousness to estimate each baseline TB state's contribution to future transmission. For a person with smear-negative subclinical TB at baseline, the expected future duration of disease was short (mean 4.8 [95% uncertainty interval 3.3 to 8.4] mo); nearly all disease courses ended in spontaneous resolution, not treatment. In contrast, people with baseline smear-positive subclinical TB had longer undiagnosed disease durations (15.9 [11.1 to 23.5] mo); nearly all eventually developed symptoms and ended in treatment or death. Despite accounting for only 11 to 19% of prevalent disease, smear-positive subclinical TB accounted for 35 to 51% of future transmission-a greater contribution than symptomatic or smear-negative TB. Subclinical TB with a high bacterial burden accounts for a disproportionate share of future transmission. Priority should be given to developing inexpensive, easy-to-use assays for screening both symptomatic and asymptomatic individuals at scale-akin to rapid antigen tests for other diseases-even if these assays lack the sensitivity to detect paucibacillary disease.
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