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Peer-reviewedCC BYBMC infectious diseases

The prevalence and proportion of asymptomatic tuberculosis among adolescents and young adults: a systematic review and meta-analysis.

  • Mohammad E Heidari1
  • Nicolas Ngo1
  • Chawangwa Modongo2
  • Amyn A Malik3,4
  • Maria R Jaswal5
  • Adrienne E Shapiro6,7
  • Rebecca H Berhanu8,9
  • Neil A Martinson10,11
  • Limakatso Lebina12
  • Stefan Niemann13,14,15
  • James A Seddon16,17
  • Sanghyuk S Shin18
18 affiliations
  1. 1Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, USA.
  2. 2Victus Global Botswana Organization, Gaborone, Botswana.
  3. 3O'Donnell School of Public Health, UT Southwestern Medical Center, Dallas, TX, USA.
  4. 4IRD Global, Singapore, Singapore.
  5. 5Baitussalam Welfare Trust, Karachi, Pakistan.
  6. 6Department of Global Health, University of Washington, Seattle, WA, USA.
  7. 7Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington, Seattle, WA, USA.
  8. 8University of the Witwatersrand, Johannesburg, South Africa.
  9. 9Department of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, USA.
  10. 10Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, USA.
  11. 11Johns Hopkins University Center for TB Research, Baltimore, USA.
  12. 12Africa Health Research Institute, Clinical Trials Unit, KwaZulu-Natal, South Africa.
  13. 13Research Center Borstel, Leibniz Lung Center, Borstel, Germany.
  14. 14German Center for Infection Research, Partner Site Hamburg-Lübeck-Borstel-Riems, Borstel, Germany.
  15. 15EPHE, Université des Antilles, Paris, France.
  16. 16Desmond Tutu TB Centre, Department of Pediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
  17. 17Department of Infectious Disease, Imperial College London, London, UK.
  18. 18Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, USA. [email protected].
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Abstract

Background

Recent studies report ≥ 50% of people with tuberculosis (TB) have asymptomatic disease, which is likely to be infectious. Asymptomatic TB among adolescents and young adults (AYAs; defined as individuals aged 10 to 24 years) has been poorly studied. To estimate the prevalence of asymptomatic TB in the population of adolescents and young adults and the proportion of TB that remains asymptomatic in this group.Methods

A systematic review and meta-analysis were conducted using PubMed, Web of Science, Scopus, and CINAHL from inception to October 2025. Studies reporting asymptomatic TB among AYAs were included. Study quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Outcomes included (1) prevalence (asymptomatic TB cases among those screened) and (2) proportion (asymptomatic TB cases among diagnosed TB cases). Pooled estimates were calculated using mixed-effects meta-analysis. The review was registered in PROSPERO (CRD420250652821).Results

Of 3,185 articles initially found, sixteen studies were included after full-text review. Included studies were conducted in Africa (n = 8), Asia (n = 7) and Europe (n = 1). The pooled prevalence of asymptomatic TB from 11 included studies among AYAs was 1% (95% confidence interval [CI]: 1%-3%), driven by high prevalence among household contact studies. The pooled proportion of asymptomatic TB from 12 included studies among AYAs with TB was 62% (95% CI: 40% -80%).Conclusion

We found high prevalence and proportion of asymptomatic TB among AYAs in many regions, underlining the importance of symptom-agnostic screening and preventative strategies in high-risk populations.

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Cite

BibTeXRIS
BibTeX
@article{heidari2026prevalence,
  title = {{The prevalence and proportion of asymptomatic tuberculosis among adolescents and young adults: a systematic review and meta-analysis.}},
  author = {Mohammad E Heidari and Nicolas Ngo and Chawangwa Modongo and Amyn A Malik and Maria R Jaswal and Adrienne E Shapiro and Rebecca H Berhanu and Neil A Martinson and Limakatso Lebina and Stefan Niemann and James A Seddon and Sanghyuk S Shin},
  journal = {BMC infectious diseases},
  year = {2026},
  month = aug,
  doi = {10.1186/s12879-026-14156-y},
  url = {https://europepmc.org/article/MED/42968046},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - The prevalence and proportion of asymptomatic tuberculosis among adolescents and young adults: a systematic review and meta-analysis.
AU  - Mohammad E Heidari
AU  - Nicolas Ngo
AU  - Chawangwa Modongo
AU  - Amyn A Malik
AU  - Maria R Jaswal
AU  - Adrienne E Shapiro
AU  - Rebecca H Berhanu
AU  - Neil A Martinson
AU  - Limakatso Lebina
AU  - Stefan Niemann
AU  - James A Seddon
AU  - Sanghyuk S Shin
PY  - 2026
DA  - 2026/08/04
JO  - BMC infectious diseases
DO  - 10.1186/s12879-026-14156-y
UR  - https://europepmc.org/article/MED/42968046
AB  - Background  Recent studies report ≥ 50% of people with tuberculosis (TB) have asymptomatic disease, which is likely to be infectious. Asymptomatic TB among adolescents and young adults (AYAs; defined as individuals aged 10 to 24 years) has been poorly studied. To estimate the prevalence of asymptomatic TB in the population of adolescents and young adults and the proportion of TB that remains asymptomatic in this group.Methods  A systematic review and meta-analysis were conducted using PubMed, Web of Science, Scopus, and CINAHL from inception to October 2025. Studies reporting asymptomatic TB among AYAs were included. Study quality was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Outcomes included (1) prevalence (asymptomatic TB cases among those screened) and (2) proportion (asymptomatic TB cases among diagnosed TB cases). Pooled estimates were calculated using mixed-effects meta-analysis. The review was registered in PROSPERO (CRD420250652821).Results  Of 3,185 articles initially found, sixteen studies were included after full-text review. Included studies were conducted in Africa (n = 8), Asia (n = 7) and Europe (n = 1). The pooled prevalence of asymptomatic TB from 11 included studies among AYAs was 1% (95% confidence interval [CI]: 1%-3%), driven by high prevalence among household contact studies. The pooled proportion of asymptomatic TB from 12 included studies among AYAs with TB was 62% (95% CI: 40% -80%).Conclusion  We found high prevalence and proportion of asymptomatic TB among AYAs in many regions, underlining the importance of symptom-agnostic screening and preventative strategies in high-risk populations.
SN  - 1471-2334
ER  -