International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
September 24, 2026 · via Europe PMC
Asymptomatic tuberculosis among household contacts of active pulmonary tuberculosis cases: a systematic review and meta-analysis.
Alemu A, Seid G, Tayachew A, Getaneh Y, Asamene N, Tadesse G, Bitew ZW
AI summary — for doctors, generated from the abstract only
About half of TB cases found in household contacts have no symptoms, so symptom screening alone will miss many.
What was studied
A PRISMA-compliant, PROSPERO-registered systematic review and meta-analysis of 18 studies in 12 countries (46,480 household contacts).
Key findings
- Pooled TB prevalence among asymptomatic contacts was 4.0% (95% CI 2.1-5.8)
- Asymptomatic disease made up 51.0% of identified TB cases in contacts
- About 2% of TB-free asymptomatic contacts developed TB during follow-up
- Male sex, suggestive chest X-ray, smoking and drug use were associated with asymptomatic TB
Clinical relevance
Contact investigation should not rely on symptoms.
Limitations
Heterogeneity was very high (I2 about 91% for incidence), so pooled estimates are imprecise.
Add chest X-ray or other testing when screening household contacts, even those without symptoms.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
OBJECTIVE
To estimate the prevalence of asymptomatic tuberculosis (TB) among household contacts (HHC) of active pulmonary TB cases.
METHODS
This study followed the PRISMA guidelines and was registered in PROSPERO (CRD420261302883). We searched electronic databases and grey literature sources for studies published up to April 18, 2026. Studies were screened, and quality was assessed using the Joanna Briggs Institute tools. Data were analyzed using STATA version 17, and pooled values were estimated along with 95%CIs. Heterogeneity was assessed using I², and publication bias using funnel plots, Egger's test, and trim-and-fill analysis where appropriate.
RESULTS
Of the 14,885 articles searched, 18 studies conducted in 12 countries involving 46,480 participants (HHCs) were included. The pooled prevalence of TB among asymptomatic HHCs was 4.0% (95%CI: 2.1-5.8%). Asymptomatic TB accounted for 51.0% (95%CI: 39.7-62.2%) of all identified TB cases. An estimated 2% (95%CI: 0.7-3.2%; I²: 90.67%) of TB-free asymptomatic contacts at baseline developed TB during follow-up. Male sex, chest X-ray suggestive of TB, cigarette smoking, and being a drug user were associated with asymptomatic TB.
CONCLUSION
About half of TB cases among HHCs were asymptomatic, highlighting the need for integrated TB screening beyond symptoms to improve early detection and reduce transmission.
DOI
10.1016/j.ijid.2026.109139
PMID
42785623
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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