Alvin Kuo Jing Teo, Emily Lai-Ho MacLean, Greg J. Fox
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We also pooled the proportion of subclinical TB according to definitions described in published prevalence surveys.</p>\n</sec>\n<sec><st>Results:</st>\n<p>We identified 29 prevalence surveys and 71 other studies. Prevalence survey data (2002–2022) using \"absence of cough of any duration\" criteria reported higher subclinical TB prevalence than those using the stricter \"completely asymptomatic\" threshold. Prevalence estimates overlap in studies using other symptoms and cough duration. Subclinical TB in studies was commonly defined as asymptomatic TB disease. Higher prevalence was reported in high TB burden areas, community settings and immunocompetent populations. People with subclinical TB showed less extensive radiographic abnormalities, higher treatment success rates and lower mortality, although studies were few.</p>\n</sec>\n<sec><st>Conclusion:</st>\n<p>A substantial proportion of TB is subclinical. However, prevalence estimates were highly heterogeneous between settings. Most published studies incompletely characterised the phenotype of people with subclinical TB. Standardised definitions and diagnostic criteria are needed to characterise this phenotype. Further research is required to enhance case finding, screening, diagnostics and treatment options for subclinical TB.</p>\n</sec>","PeriodicalId":12166,"journal":{"name":"European Respiratory Review","volume":null,"pages":null},"PeriodicalIF":9.0000,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Subclinical tuberculosis: a meta-analysis of prevalence and scoping review of definitions, prevalence and clinical characteristics\",\"authors\":\"Alvin Kuo Jing Teo, Emily Lai-Ho MacLean, Greg J. Fox\",\"doi\":\"10.1183/16000617.0208-2023\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<sec><st>Background:</st>\\n<p>This scoping review aimed to characterise definitions used to describe subclinical tuberculosis (TB), estimate the prevalence in different populations and describe the clinical characteristics and treatment outcomes in the scientific literature.</p>\\n</sec>\\n<sec><st>Methods:</st>\\n<p>A systematic literature search was conducted using PubMed. We included studies published in English between January 1990 and August 2022 that defined \\\"subclinical\\\" or \\\"asymptomatic\\\" pulmonary TB disease, regardless of age, HIV status and comorbidities. We estimated the weighted pooled proportions of subclinical TB using a random-effects model by World Health Organization reported TB incidence, populations and settings. We also pooled the proportion of subclinical TB according to definitions described in published prevalence surveys.</p>\\n</sec>\\n<sec><st>Results:</st>\\n<p>We identified 29 prevalence surveys and 71 other studies. Prevalence survey data (2002–2022) using \\\"absence of cough of any duration\\\" criteria reported higher subclinical TB prevalence than those using the stricter \\\"completely asymptomatic\\\" threshold. Prevalence estimates overlap in studies using other symptoms and cough duration. Subclinical TB in studies was commonly defined as asymptomatic TB disease. Higher prevalence was reported in high TB burden areas, community settings and immunocompetent populations. People with subclinical TB showed less extensive radiographic abnormalities, higher treatment success rates and lower mortality, although studies were few.</p>\\n</sec>\\n<sec><st>Conclusion:</st>\\n<p>A substantial proportion of TB is subclinical. 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Subclinical tuberculosis: a meta-analysis of prevalence and scoping review of definitions, prevalence and clinical characteristics
Background:
This scoping review aimed to characterise definitions used to describe subclinical tuberculosis (TB), estimate the prevalence in different populations and describe the clinical characteristics and treatment outcomes in the scientific literature.
Methods:
A systematic literature search was conducted using PubMed. We included studies published in English between January 1990 and August 2022 that defined "subclinical" or "asymptomatic" pulmonary TB disease, regardless of age, HIV status and comorbidities. We estimated the weighted pooled proportions of subclinical TB using a random-effects model by World Health Organization reported TB incidence, populations and settings. We also pooled the proportion of subclinical TB according to definitions described in published prevalence surveys.
Results:
We identified 29 prevalence surveys and 71 other studies. Prevalence survey data (2002–2022) using "absence of cough of any duration" criteria reported higher subclinical TB prevalence than those using the stricter "completely asymptomatic" threshold. Prevalence estimates overlap in studies using other symptoms and cough duration. Subclinical TB in studies was commonly defined as asymptomatic TB disease. Higher prevalence was reported in high TB burden areas, community settings and immunocompetent populations. People with subclinical TB showed less extensive radiographic abnormalities, higher treatment success rates and lower mortality, although studies were few.
Conclusion:
A substantial proportion of TB is subclinical. However, prevalence estimates were highly heterogeneous between settings. Most published studies incompletely characterised the phenotype of people with subclinical TB. Standardised definitions and diagnostic criteria are needed to characterise this phenotype. Further research is required to enhance case finding, screening, diagnostics and treatment options for subclinical TB.
期刊介绍：
The European Respiratory Review (ERR) is an open-access journal published by the European Respiratory Society (ERS), serving as a vital resource for respiratory professionals by delivering updates on medicine, science, and surgery in the field. ERR features state-of-the-art review articles, editorials, correspondence, and summaries of recent research findings and studies covering a wide range of topics including COPD, asthma, pulmonary hypertension, interstitial lung disease, lung cancer, tuberculosis, and pulmonary infections. Articles are published continuously and compiled into quarterly issues within a single annual volume.
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