Transmissibility and Disease Progression of Asymptomatic Mycobacterium tuberculosis Infection, Lima, Peru

Wang R.; Huang C.-C.; Becerra M.C.; Calderon R.I.; Contreras C.C.; Galea J.T.; Jimenez J.; Lecca L.; Yataco R.M.; Zhang Z.; Murray M.B. · Emerging Infectious Diseases (2026) · DOI: 10.3201/eid3204.251947

Resumen

Estimating the transmissibility of asymptomatic Myco bacterium tuberculosis infection can clarify its contribu tion to tuberculosis (TB) spread. We conducted a pro spective cohort study in Lima, Peru, enrolling index TB patients and their household contacts (HHCs) and clas sifying patients by the presence of symptoms including cough, night sweats, weight loss, or fever. We followed HHCs with serial tuberculin skin testing and clinical evaluations. Among 4,296 child HHCs, adjusted esti mates for baseline infection (prevalence ratio 0.62 [95% CI 0.37–1.03]), incident infection at 6 months (hazard ratio (aHR) 0.63 [95% CI 0.27–1.49]), and TB disease during 1 year of follow-up (aHR 0.74 [95% CI 0.35 1.56]) were all consistent with lower risk for infection and disease progression among HHCs of asymptomatic compared with symptomatic index patients. Although asymptomatic infections may be less transmissible than symptomatic infections, the high prevalence of asymp tomatic patients in national surveys suggest that they may contribute substantially to transmission.

Instituciones: Universidad de San Martín de Porres