Chest Radiograph Screening for Detecting Subclinical Tuberculosis in Asymptomatic Household Contacts, Peru

• Published in: Emerging infectious diseases 2024-06, Vol.30 (6), p.1115-1124
• Main Authors: Tan, Qi, Huang, Chuan-Chin, Becerra, Mercedes C, Calderon, Roger, Contreras, Carmen, Lecca, Leonid, Jimenez, Judith, Yataco, Rosa, Galea, Jerome T, Feng, Jia-Yih, Pan, Sheng-Wei, Tseng, Yen-Han, Huang, Jhong-Ru, Zhang, Zibiao, Murray, Megan B
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Asthma; Asymptomatic; bacteria; Cardiovascular disease; Care and treatment; chest radiography; Child; Child, Preschool; Cohort analysis; Contact Tracing - methods; Diabetes; Diagnosis; Enrollments; Epidemiologic methods; Evaluation; Family Characteristics; Female; Health facilities; HIV; Households; Human immunodeficiency virus; Humans; Hypertension; Infant; Kidney diseases; Latent Tuberculosis - diagnosis; Latent Tuberculosis - diagnostic imaging; Latent Tuberculosis - epidemiology; Longitudinal Studies; Male; mass chest x-ray; Mass Screening - methods; Medical research; Medicine, Experimental; Middle Aged; Peru - epidemiology; Public health; Public health administration; pulmonary; Radiography, Medical; Radiography, Thoracic; subclinical infections; Tuberculosis; Tuberculosis - diagnosis; Tuberculosis - diagnostic imaging; Tuberculosis - epidemiology; tuberculosis and other mycobacteria; Tuberculosis, Pulmonary - diagnosis; Tuberculosis, Pulmonary - diagnostic imaging; Tuberculosis, Pulmonary - epidemiology; Young Adult; Young adults
• ISSN: 1080-6040; 1080-6059; 1080-6059
• DOI: 10.3201/eid3006.231699

The World Health Organization's end TB strategy promotes the use of symptom and chest radiograph screening for tuberculosis (TB) disease. However, asymptomatic early states of TB beyond latent TB infection and active disease can go unrecognized using current screening criteria. We conducted a longitudinal cohort study enrolling household contacts initially free of TB disease and followed them for the occurrence of incident TB over 1 year. Among 1,747 screened contacts, 27 (52%) of the 52 persons in whom TB subsequently developed during follow-up had a baseline abnormal radiograph. Of contacts without TB symptoms, persons with an abnormal radiograph were at higher risk for subsequent TB than persons with an unremarkable radiograph (adjusted hazard ratio 15.62 [95% CI 7.74-31.54]). In young adults, we found a strong linear relationship between radiograph severity and time to TB diagnosis. Our findings suggest chest radiograph screening can extend to detecting early TB states, thereby enabling timely intervention.