Asymptomatic tuberculosis detected in health screening predicts favourable outcome

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 and treatment outcomes. Individuals with rifampicin-susceptible pulmonary tuberculosis were enrolled from the Cohort Study of Pulmonary Tuberculosis. Asymptomatic tuberculosis was defined as the absence of any tuberculosis-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 tuberculosis and favourable outcomes. Cox proportional hazards model was applied to evaluate effect of asymptomatic tuberculosis on failure to complete treatment within one year. Stratified analyses by symptom status and mode of detection were performed to examine stratum-specific effects. Results Of 1071 individuals with pulmonary tuberculosis, 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 tuberculosis was associated with higher likelihood of favourable outcome in multivariable models (adjusted odds ratio[aOR], 1.50; 95% confidence interval [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 tuberculosis detected through health screening had the most favourable outcomes (aOR, 2.41; 95% CI, 1.34–4.66). Conclusion Asymptomatic tuberculosis was significantly associated with treatment success without recurrence, and particularly in patients identified through health screening. Our results support symptom-agnostic screening in tuberculosis control programs.

Authors

Institutions

Publication Details

Journal
ERJ Open Research
Published
2025-12-04
DOI
https://doi.org/10.1183/23120541.01162-2025
Primary Topic
Tuberculosis Research and Epidemiology
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Asymptomatic tuberculosis detected in health screening predicts favourable outcome

Sun Jung Kwon, Eung Gu Lee, Jinsoo Min, Sun‐Hyung Kim et al.
ERJ Open Research
Tuberculosis Research and Epidemiology
article

Asymptomatic tuberculosis detected in health screening predicts favourable outcome

Sun Jung Kwon, Eung Gu Lee, Jinsoo Min, Sun‐Hyung Kim, Jee Youn Oh, Jiwon Lyu, Molebogeng Xheedha Rangaka, Ju Sang Kim, Hyeon‐Kyoung Koo, Ganghee Chae, Yoolwon Jeong, Marc Lipman, Sung Soo Jung, Heayon Lee, Yun‐Jeong Jeong, Jin Woo Kim, Hyung Woo Kim, Seung Hoon Kim, Sang‐Jun Park, Yeonhee Park, Do Jin Kim
article en

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 and treatment outcomes. Individuals with rifampicin-susceptible pulmonary tuberculosis were enrolled from the Cohort Study of Pulmonary Tuberculosis. Asymptomatic tuberculosis was defined as the absence of any tuberculosis-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 tuberculosis and favourable outcomes. Cox proportional hazards model was applied to evaluate effect of asymptomatic tuberculosis on failure to complete treatment within one year. Stratified analyses by symptom status and mode of detection were performed to examine stratum-specific effects. Results Of 1071 individuals with pulmonary tuberculosis, 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 tuberculosis was associated with higher likelihood of favourable outcome in multivariable models (adjusted odds ratio[aOR], 1.50; 95% confidence interval [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 tuberculosis detected through health screening had the most favourable outcomes (aOR, 2.41; 95% CI, 1.34–4.66). Conclusion Asymptomatic tuberculosis was significantly associated with treatment success without recurrence, and particularly in patients identified through health screening. Our results support symptom-agnostic screening in tuberculosis control programs.

ERJ Open Research
University College Hospital (GB), Konyang University (KR), Soonchunhyang University (KR), Korea University Medical Center (KR), Soonchunhyang University Hospital Seoul (KR), MRC Clinical Trials Unit at UCL (GB), St. Mary's Hospital (US), The Catholic University of Korea St. Vincent's Hospital (KR), The Catholic University of Korea Incheon St. Mary's Hospital (KR), Konyang University Hospital (KR), Dongguk University Ilsan Hospital (KR), The Catholic University of Korea Uijeongbu St. Mary's Hospital (KR), Inje University Ilsan Paik Hospital (KR), St. Mary's Hospital (US), The Catholic University of Korea Bucheon St. Mary's Hospital (KR), Ulsan University Hospital (KR), Chungnam National University Hospital (KR), The Catholic University of Korea Seoul St. Mary's Hospital (KR), Chungbuk National University Hospital (KR), Korea University (JP), Dankook University Hospital (KR), University College London (GB), Bucheon University (KR), Medical Research Council (GB)
Openalex Percentile: Top 55%
Tuberculosis Research and Epidemiology
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.