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Beyond latent and active tuberculosis: a scoping review of conceptual frameworks

Zaidi, SMA; Coussens, AK; Seddon, JA; Kredo, T; Warner, D; Houben, RMGJ; Esmail, H; (2023) Beyond latent and active tuberculosis: a scoping review of conceptual frameworks. eClinicalMedicine , 66 , Article 102332. 10.1016/j.eclinm.2023.102332. Green open access

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Abstract

There is growing recognition that tuberculosis (TB) infection and disease exists as a spectrum of states beyond the current binary classification of latent and active TB. Our aim was to systematically map and synthesize published conceptual frameworks for TB states. We searched MEDLINE, Embase and EMcare for review articles from 1946 to September 2023. We included 40 articles that explicitly described greater than two states for TB. We identified that terminology, definitions and diagnostic criteria for additional TB states within these articles were inconsistent. Eight broad conceptual themes were identified that were used to categorize TB states: State 0: Mycobacterium tuberculosis (Mtb) elimination with innate immune response (n = 25/40, 63%); State I: Mtb elimination by acquired immune response (n = 31/40, 78%); State II: Mtb infection not eliminated but controlled (n = 37/40, 93%); State III: Mtb infection not controlled (n = 24/40, 60%); State IV: bacteriologically positive without symptoms (n = 26/40, 65%); State V: signs or symptoms associated with TB (n = 39/40, 98%); State VI: severe or disseminated TB disease (n = 11/40, 28%); and State VII: previous history of TB (n = 5/40, 13%). Consensus on a non-binary framework that includes additional TB states is required to standardize scientific communication and to inform advancements in research, clinical and public health practice.

Type: Article
Title: Beyond latent and active tuberculosis: a scoping review of conceptual frameworks
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.eclinm.2023.102332
Publisher version: https://doi.org/10.1016/j.eclinm.2023.102332
Language: English
Additional information: © 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Tuberculosis; Conceptual framework; Spectrum; Latent tuberculosis; Incipient tuberculosis; Subclinical tuberculosis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
URI: https://discovery-pp.ucl.ac.uk/id/eprint/10184762
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