Towards an appropriate treatment for subclinical tuberculosis: A mixed-method exploration among patients, health workers and stakeholders

Tuberculosis (TB) case-finding and control is complicated by the fact that about half of bacteriologically confirmed TB cases don’t have any clinical symptoms. It has long been thought that only symptomatic patients with active pulmonary TB spread the disease. However, new data suggest that transmission may occur in the absence of cough or other TB symptoms therefore subclinical TB (scTB1) has to be considered an important factor for TB transmission.
Upon microbiological confirmation or clinical diagnosis of TB disease, treatment should be initiated promptly. However, the WHO TB treatment guidelines currently do not specifically cover scTB. Following treatment recommendations for symptomatic TB disease may subject individuals who feel otherwise well to a potentially unnecessary high pill burden and side effects. Furthermore, TB treatment is associated with substantial, often catastrophic patient costs. These factors put enormous strains on affected people, raising concerns about treatment willingness and adherence.

The general objective of this project is the assessment of the current landscape of treatment options for individuals diagnosed with scTB in a high TB burden country, Tanzania, and to inform treatment strategies based on patient and health worker consultations.