Asymptomatic tuberculosis detected in health screening predicts favourable outcome
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: The clinical and prognostic implications of asymptomatic tuberculosis remain poorly understood. Methods: We conducted a multicentre prospective cohort study to evaluate the association between asymptomatic tuberculosis (TB) and treatment outcomes. Individuals with rifampicin-susceptible pulmonary TB were enrolled from the Cohort Study of Pulmonary Tuberculosis. Asymptomatic TB was defined as the absence of any TB-related symptoms at diagnosis. The primary outcome was a favourable outcome, defined as treatment success without recurrence. Multivariable logistic regression models were used to assess associations between asymptomatic TB and favourable outcomes. The Cox proportional hazards model was applied to evaluate effect of asymptomatic TB on failure to complete treatment within 1 year. Stratified analyses by symptom status and mode of detection were performed to examine stratum-specific effects. Results: Of 1071 individuals with pulmonary TB, 32.7% were asymptomatic. Compared to symptomatic patients, asymptomatic individuals were younger, less likely to be underweight and more often diagnosed through population health screening rather than clinical presentation or opportunistic testing. Asymptomatic TB was associated with higher likelihood of favourable outcome in multivariable models (adjusted odds ratio (aOR) 1.50, 95% CI 1.04-2.20) and a reduced risk of failing to complete treatment within one year in survival analyses (adjusted hazard ratio 0.66, 95% CI 0.45-0.95). Asymptomatic TB detected through health screening had the most favourable outcomes (aOR 2.41, 95% CI 1.34-4.66). Conclusion: Asymptomatic TB was significantly associated with treatment success without recurrence and particularly in patients identified through health screening. Our results support symptom-agnostic screening in TB control programmes.
Source: ERJ Open Research
Authors: Sangjun Park, Hyung Woo Kim, Eung Gu Lee, Yeonhee Park, Sung Soo Jung, Jin Woo Kim, Jee Youn Oh, Heayon Lee, Seung Hoon Kim, Sun-Hyung Kim, Jiwon Lyu, Sun Jung Kwon, Yun-Jeong Jeong, Do Jin Kim, Hyeon-Kyoung Koo, Ganghee Chae, Yoolwon Jeong, Ju Sang Kim, Molebogeng X. Rangaka, Marc Lipman, Jinsoo Min
Institutions: The Catholic University of Korea Seoul St. Mary's Hospital, Catholic University of Korea, The Catholic University of Korea Incheon St. Mary's Hospital, The Catholic University of Korea Bucheon St. Mary's Hospital, The Catholic University of Korea Daejeon St. Mary's Hospital, Chungnam National University, Chungnam National University Hospital, The Catholic University of Korea Uijeongbu St. Mary's Hospital, Soonchunhyang University Hospital Bucheon, Korea University, Korea University Guro Hospital, The Catholic University of Korea Eunpyeong St. Mary's Hospital, Chungbuk National University, The Catholic University of Korea St. Vincent's Hospital, Chungbuk National University Hospital, Soonchunhyang University, Soonchunhyang University Hospital Cheonan, Konyang University, Konyang University Hospital, Ewha Womans University, Dongguk University Ilsan Hospital, Inje University, Inje University Ilsan Paik Hospital, University of Ulsan, Ulsan University Hospital, Dankook University Hospital, University of Cape Town, MRC Clinical Trials Unit at UCL, Wellcome Centre for Infectious Diseases Research in Africa, Institute of Infectious Disease and Molecular Medicine, University College London, Medical Research Council, Royal Free London NHS Foundation Trust
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $808
Awards: G6392363135, G7803742634
OpenAlex ID: W4416995326