We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
How "Subclinical" is Subclinical Tuberculosis? An Analysis of National Prevalence Survey Data from Zambia.
- Authors
Stuck, Logan; Haaster, Aimee Claire van; Kapata-Chanda, Pascalina; Klinkenberg, Eveline; Kapata, Nathan; Cobelens, Frank
- Abstract
Background Pulmonary tuberculosis infection can manifest in different states, including subclinical tuberculosis. It is commonly defined as confirmed tuberculosis without the classic symptoms (commonly, persistent cough for ≥2 weeks). This narrow definition likely poses limitations for surveillance and control measures. The aims of the current study were to characterize the clinical presentation of tuberculosis; estimate the prevalence of subclinical tuberculosis among individuals with bacteriologically confirmed tuberculosis, using various definitions; and investigate risk factors for subclinical as opposed to clinical tuberculosis in a population-based survey. Methods We conducted a secondary analysis of data from a nationally representative tuberculosis prevalence survey from Zambia in 2013–2014, in which participants were screened for tuberculosis based on chest radiographic findings and symptoms. Tuberculosis was defined as culture-positive or GeneXpert MTB/RIF test–positive sputum. Risk factors for subclinical tuberculosis were assessed by means of multivariable logistic regression. Results Of 257 participants with confirmed tuberculosis, 104 (40.5%) were without cough persisting ≥2 weeks. Only 23 (22.1%) of these did not present with any other common symptoms. Those without cough persisting ≥2 weeks frequently reported other symptoms, particularly chest pain (46.2%) and weight loss (38.5%); 36 (34.6%) reported experiencing other symptoms persisting ≥4 weeks. Female subjects were more likely to report no cough persisting ≥2 weeks, as were relatively wealthier individuals. Conclusions The commonly used definition of subclinical tuberculosis includes a large proportion of individuals who have other tuberculosis-suggestive symptoms. Requiring cough ≥2 weeks for tuberculosis diagnosis likely misses many active tuberculosis infections and allows a large reservoir of likely transmissible tuberculosis to remain undetected.
- Subjects
ZAMBIA; TUBERCULOSIS epidemiology; TUBERCULOSIS diagnosis; TUBERCULOSIS risk factors; CHEST X rays; MULTIPLE regression analysis; SPUTUM; SEX distribution; TUBERCULOSIS; DISEASE prevalence; COUGH; CHEST pain; WEIGHT loss; DESCRIPTIVE statistics; SECONDARY analysis; SYMPTOMS
- Publication
Clinical Infectious Diseases, 2022, Vol 75, Issue 5, p842
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciab1050