Cough is not the typical symptom of tuberculosis as previously thought: a study on over 600 thousand individuals shows that in 4 out of 5 cases tuberculosis patients do not have a persistent cough and in over 3 out of 5 cases they have no cough at all. The study was conducted at the Medical University of Amsterdam and just published on Lancet Infectious Diseases.
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How the infection is transmitted
The infection is mainly transmitted by coughing, but probably also by simple breathing. Analyzing data on more than 600,000 individuals in Africa and Asia the team found that 82.8% of those suffering from tuberculosis did not have a persistent cough and 62.5% had no cough at all.
“Our findings point to the likely reason why, despite enormous efforts to diagnose and treat the disease, the burden of tuberculosis (TB) in Africa and Asia is not decreasing. We already knew there was a huge discrepancy between the 10 .6 million people falling ill with tuberculosis and 7.5 million cases recorded by health authorities in 2022,” he says Frank Cobelensprofessor of Global Health at Amsterdam UMC.
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A quarter of patients without symptoms
“Persistent cough is often the starting point for the diagnosis – he continues Cobelens – but if 80% of those with TB do not suffer from it, it means that the diagnosis will occur late, after the infection has already been transmitted to many other people.” The analysis also highlighted that, together with the lack of cough, more than a quarter of patients have no symptoms at all. Both of these traits are more common in women than in men. Furthermore, the study showed that a quarter of patients without a cough have a high bacterial load in their mucus, so it is probably very infectious.”We really need to rethink how we identify people with TB. It is clear that current practices are not adequate to recognize all patients with TB,” concludes the author
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