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Incipient and subclinical tuberculosis: a narrative review
1Department of Pulmonary Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh.
Tuberculosis (TB) is an airborne disease with a spectrum of infection, including early stages like incipient and subclinical TB. Early detection and treatment are crucial for the global end-TB strategy.
Area of Science:
- Infectious Diseases
- Immunology
- Public Health
Background:
- Tuberculosis (TB) is an ancient airborne infectious disease caused by Mycobacterium tuberculosis.
- Historically, TB was viewed as distinct infection or active disease, but a dynamic spectrum is now recognized.
- This spectrum includes TB infection, incipient TB, subclinical TB, and active TB disease, influenced by host and pathogen factors.
Purpose of the Study:
- To review the definition, natural history, burden, trajectory, transmissibility, detection, and management of early-stage TB.
- To highlight the importance of including incipient and subclinical TB in the end-TB strategy.
- To emphasize early diagnosis and treatment for meeting global TB elimination targets.
Main Methods:
- This review synthesizes current knowledge on early-stage TB.
- It focuses on the characteristics and progression of TB infection stages.
- Literature review and analysis of epidemiological data on TB burden and transmission.
Main Results:
- Subclinical TB, often asymptomatic, can contribute to community TB spread due to delayed diagnosis.
- Individuals with subclinical TB may remain in this stage indefinitely, progress to active disease, or even regress.
- Host and pathogen factors significantly influence an individual's position within the TB infection spectrum.
Conclusions:
- Early diagnosis and management of all stages of TB, including incipient and subclinical forms, are vital for achieving the 2035 end-TB targets.
- Understanding the dynamic spectrum of TB infection is essential for effective public health interventions.
- A comprehensive strategy must address the challenges posed by asymptomatic and subclinical TB cases to curb transmission.
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