Current approaches for diagnosis of subclinical pulmonary tuberculosis, clinical implications and future perspectives: a scoping review

ABSTRACT

Introduction

Subclinical tuberculosis (TB) is the presence of TB disease among people who are either asymptomatic or have minimal symptoms.

Areas covered

Currently, there are no accurate diagnostic tools and clear treatment approaches for subclinical TB. In this study, a comprehensive literature search was conducted across major databases. This review aimed to uncover the latest advancements in diagnostic approaches, explore their clinical implications, and outline potential future perspectives. While innovative technologies are in development to enable sputum-free TB tests, there remains a critical need for precise diagnostic tools tailored to the unique characteristics of subclinical TB. Given the complexity of subclinical TB, a multidisciplinary approach involving clinicians, microbiologists, epidemiologists, and public health experts is essential. Further research is needed to establish standardized diagnostic criteria and treatment guidelines specifically tailored for subclinical TB, acknowledging the unique challenges posed by this elusive stage of the disease.

Expert opinion

Efforts are needed for the detection, diagnosis, and treatment of subclinical TB. In this review, we describe the importance of subclinical TB, both from a clinical and public health perspective and highlight the diagnostic and treatment gaps of this stage.

KEYWORDS:

• Subclinical tuberculosis
• diagnostic
• treatment
• transmission
• tuberculosis

Article highlights

• Subclinical tuberculosis (TB) represents a challenging stage of the disease characterized by the presence of TB infection in asymptomatic individuals.

• Current diagnostic tools for subclinical TB lack accuracy and clear treatment approaches, necessitating the exploration of innovative technologies and multidisciplinary approaches.

• Advances in diagnostic approaches, including sputum-free TB tests, are promising; however, there remains a critical need for precise diagnostic tools tailored specifically for subclinical TB.

Declaration of interests

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript.

Reviewer disclosures

One reviewer received research funding by Beckman Coulter and support by Cepheid, both to their institution. The remaining reviewers have no other relevant financial relationships or otherwise to disclose.

Availability of data and materials

All data generated or analyzed during this study are included in this published article.

Additional information

Funding

The work was supported by the Horizon Europe (HORIZON), as a research project under the “HORIZON-WIDERA-2022-TALENTS-04-01” program [Project Number: 101130873- DET-TB. The work of SM received partial support from the European Commission-European Research Executive Agency (REA) under grant agreement No. 101130873.