Evidence map›Paper›PMID 41092118›Full record

ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2026

Asymptomatic Tuberculosis in Children With Household Exposure to Mycobacterium tuberculosis.

Humphrey Mulenga, Justin Shenje, Simon C Mendelsohn, Angelique K K Luabeya, Michele Tameris, Enid N Tredoux, Elisa Nemes, Nicole Bilek, Elisabeth Beyers, Dejana Ivacik-Goncalves and 7 more

Abstract read
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In one paragraph

Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Humphrey MulengaSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.ORCID 0000-0002-2030-0751
Justin ShenjeSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Simon C MendelsohnSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.ORCID 0000-0002-4054-2766
Angelique K K LuabeyaSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Michele TamerisSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.ORCID 0000-0002-7983-7203
Enid N TredouxSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.ORCID 0009-0000-5601-3466
Elisa NemesSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.ORCID 0000-0003-1662-4961
Nicole BilekSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Elisabeth BeyersSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Dejana Ivacik-GoncalvesSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.
Jason R AndrewsDivision of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA.
Thomas R HawnDepartment of Medicine, University of Washington, Seattle, Washington, USA.
Karen M DobosDepartment of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado, USA.ORCID 0000-0001-7115-8524
John A AltinPathogen Genomics Division, The Translational Genomics Research Institute (TGen), Flagstaff, Arizona, USA.
Munyaradzi MusvosviSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.ORCID 0000-0002-4526-8479
Thomas J ScribaSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.ORCID 0000-0002-0641-1359
Mark HatherillSouth African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine and Division of Immunology, Department of Pathology, University of Cape Town, Cape Town, South Africa.ORCID 0000-0003-3491-1809

Funding

Host blood biomarkers for the diagnosis prognosis and treatment response of childhood TBR01AI143636 · NIAID · UNIVERSITY OF CAPE TOWN · PI HATHERILL, MARK · 2019 to 2024
$4.0M
National Institute of Allergy and Infectious Diseases 5R01AI143636NIAID NIH HHS R01 AI143636US National Institutes of Health
6 · The paper itself

Abstract

backgroundAsymptomatic tuberculosis (TB) is common in adult community prevalence surveys. Evidence to inform our understanding of asymptomatic TB in children is lacking, because diagnostic algorithms typically include only symptomatic children.

methodsChildren aged 2-60 months, without human immunodeficiency virus (HIV), with household exposure to an adult TB patient in the last year, were enrolled in South Africa. Symptom screening, chest radiography (CXR) and induced sputum were performed. Confirmed TB (requiring positive Xpert Ultra and/or MGIT culture) and unconfirmed TB (requiring 2 of TB exposure, compatible symptoms, or compatible CXR) were defined by application of a consensus case definition for classification of childhood TB. Asymptomatic TB was defined as Confirmed or Unconfirmed TB without reported symptoms.

resultsIn brief, 430 TB-exposed children, median age 25.9 (interquartile range [IQR] 13.5-40.0) months, were enrolled. And 154 (35.8%) children met TB diagnostic criteria, including 21 (4.9%) Confirmed and 133 (30.9%) Unconfirmed cases. Fifty-five (35.7%) of all TB cases were asymptomatic, including 17/21 (81.0%) Confirmed and 38/133 (28.6%) Unconfirmed cases. CXR was compatible with TB in 30/41 (73.2%) asymptomatic versus 15/47 (31.9%) symptomatic cases who underwent CXR (P < .001). TB treatment was started in 44/55 (80%) asymptomatic versus 34/99 (34.3%) symptomatic cases (P < .001). Factors associated with asymptomatic compared to symptomatic TB included microbiological confirmation (adjusted odds ratio [aOR] = 3.73; 95% confidence interval [CI]: 1.08-12.88).

conclusionsAsymptomatic TB that meets the consensus case definitions for both Confirmed and Unconfirmed disease is common in TB-exposed children. All child household contacts should be actively investigated for TB, regardless of symptoms, before a decision is made on curative or preventive therapy.

Indexed as

Asymptomatic InfectionsMycobacterium tuberculosisTuberculosisChild, PreschoolFamily CharacteristicsFemaleHumansInfantMalePrevalenceRadiography, ThoracicSouth AfricaSputumasymptomaticchildrencontacthouseholdtuberculosis

Identifiers

PMID41092118
PMCPMC13189671

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Registered trials

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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.