Year: 2023
Type: review
Study design: Systematic Review
Abstract: There is growing recognition that tuberculosis (TB) infection and disease exists as a spectrum of states beyond the current binary classification of latent and active TB. Our aim was to systematically map and synthesize published conceptual frameworks for TB states. We searched MEDLINE, Embase and EMcare for review articles from 1946 to September 2023. We included 40 articles that explicitly described greater than two states for TB. We identified that terminology, definitions and diagnostic criteria for additional TB states within these articles were inconsistent. Eight broad conceptual themes were identified that were used to categorize TB states: State 0: Mycobacterium tuberculosis ( Mtb ) elimination with innate immune response (n = 25/40, 63%); State I: Mtb elimination by acquired immune response (n = 31/40, 78%); State II: Mtb infection not eliminated but controlled (n = 37/40, 93%); State III: Mtb infection not controlled (n = 24/40, 60%); State IV: bacteriologically positive without symptoms (n = 26/40, 65%); State V: signs or symptoms associated with TB (n = 39/40, 98%); State VI: severe or disseminated TB disease (n = 11/40, 28%); and State VII: previous history of TB (n = 5/40, 13%). Consensus on a non-binary framework that includes additional TB states is required to standardize scientific communication and to inform advancements in research, clinical and public health practice.
Source: EClinicalMedicine
Institutions: MRC Clinical Trials Unit at UCL, National University of Medical Sciences, University College London, University of Cape Town, The University of Melbourne, Walter and Eliza Hall Institute of Medical Research, Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, Stellenbosch University, Imperial College London, South African Medical Research Council, London School of Hygiene & Tropical Medicine
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $5,000
Funders: UK Research and Innovation, Commonwealth Scholarship Commission, Walter and Eliza Hall Institute, Medical Research Council, European Research Council, National Health and Medical Research Council, Great Ormond Street Institute of Child Health, Medical Research Foundation, H2020 European Research Council
Awards: MICA: Radio+ TB trial development: Determining the optimal regimen for bacteriologically negative, radiographically apparent TB diagnosed usingnewtest, G2035441819, Respiratory infections, G4632002895, G4777944076, Translating and field-validating an epigenetic blood test to predict TB infection and disease risk, G6725874233, What is Tuberculosis? Challenging the Current Paradigm of Tuberculosis Natural History using Mathematical Modelling Techniques
OpenAlex ID: W4388776173