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The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
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Longitudinal symptom transitions predict incident tuberculosis risk in serial active case finding.
Esther Jung1, José Victor Bortolotto Bampi2, Alessandra Moura da Silva2
1Stanford University School of Medicine, Stanford, California, United States.
The Journal of Infectious Diseases
|February 20, 2026
Summary
Monitoring symptoms over time can improve tuberculosis (TB) screening in high-risk groups. Developing new symptoms, especially with prior chest imaging abnormalities, significantly increases TB risk.
Area of Science:
- Public Health
- Infectious Disease Epidemiology
- Clinical Screening
Background:
- Tuberculosis (TB) screening commonly uses single-time point symptom checks.
- There is a need to evaluate more dynamic approaches for TB detection.
Purpose of the Study:
- To assess the added value of longitudinal symptom monitoring for TB screening.
- To identify specific symptom patterns associated with incident TB in a high-risk population.
Main Methods:
- A prospective cohort study was conducted with 2,282 incarcerated men in Brazil.
- Participants underwent symptom assessments and TB testing (Xpert/culture) every four months.
- Statistical analysis included adjusted risk ratios (aRR) to compare TB risk based on symptom status.
Main Results:
- Developing new symptoms was linked to a 2.31-fold increased risk of TB.
- This association was strongest (aRR 2.49) in individuals with prior radiographic abnormalities.
- Persistently symptomatic individuals did not show a significant association with incident TB (aRR 1.27).
Conclusions:
- Longitudinal symptom monitoring can enhance TB screening effectiveness in correctional settings.
- Combining symptom tracking with radiography may further improve early TB detection in vulnerable populations.
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