Prevalence of subclinical pulmonary tuberculosis in adults in community settings: an individual participant data meta-analysis
Analysis (n=602 863 [1944 had TB], Africa, Asia) noted majority of people in community with pulmonary TB do not report cough, a quarter report no TB-suggestive symptoms at all, and a quarter of those not reporting any cough have positive sputum smears, suggesting infectiousness.
Source:
The Lancet Infectious Diseases
SPS commentary:
A commentary notes that unlike preventive TB treatment, management of subclinical TB needs to be given full legal and public health consideration, because subclinical disease contributes to transmission. It points out subclinical TB management is challenging, as patients tend to be less motivated for treatment and less likely to adhere to regimens given their absence of or minimal symptoms. It suggests digital adherence tools, such as tools on mobile applications or electronic medical monitors, could be helpful. It concludes that subclinical TB hides a higher prevalence of TB and poses an imminent challenge to WHO's target of ending the disease by 2035.