Classification of early tuberculosis states to guide research for improved care and prevention: an international Delphi consensus exercise

被引:55
作者
Coussens, Anna K. [2 ,3 ]
Zaidi, Syed M. A. [4 ,5 ,6 ]
Allwood, Brian W. [7 ,8 ]
Dewan, Puneet K. [9 ]
Gray, Glenda [10 ]
Kohli, Mikashmi [11 ,13 ]
Kredo, Tamara [10 ]
Marais, Ben J. [12 ,14 ]
Marks, Guy B. [15 ]
Martinez, Leo [16 ]
Ruhwald, Morten [11 ,13 ]
Scriba, Thomas J. [1 ,2 ]
Seddon, James A. [17 ,18 ]
Tisile, Phumeza [19 ]
Warner, Digby F. [2 ]
Wilkinson, Robert J. [17 ,20 ]
Esmail, Hanif [4 ,5 ,23 ]
Houben, Rein M. G. J. [21 ,22 ]
机构
[1] Walter & Eliza Hall Inst Med Res WEHI, Infect Dis & Immune Def Div, Parkville, Vic, Australia
[2] Univ Cape Town, Ctr Infect Dis Res Africa, Cape Town, South Africa
[3] Univ Cape Town, South African TB Vaccine Initiat, Cape Town, South Africa
[4] Univ Cape Town, Inst Infect Dis & Mol Med, Cape Town, South Africa
[5] Univ Cape Town, Dept Pathol, Cape Town, South Africa
[6] Univ Melbourne, Dept Med Biol, Parkville, Vic, Australia
[7] UCL, Inst Global Hlth, WHO Collaborating Ctr TB Res & Innovat, London, England
[8] UCL, MRC Clin Trials Unit, London, England
[9] Natl Univ Med Sci, Dept Publ Hlth, Rawalpindi, Pakistan
[10] Stellenbosch Univ, Dept Med, Div Pulmonol, Stellenbosch, South Africa
[11] Bill & Melinda Gates Fdn, TB & HIV, Seattle, WA USA
[12] South African Med Res Council, Hlth Syst Res Unit, Cape Town, South Africa
[13] FIND, Hlth Programmes, Geneva, Switzerland
[14] Univ Sydney, Sydney Infect Dis Inst, WHO Collaborating Ctr TB, Sydney, NSW, Australia
[15] Univ Sydney, Fac Med & Hlth, Dept Clin Med, Sydney, NSW, Australia
[16] Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA USA
[17] Imperial Coll London, Dept Infect Dis, London, England
[18] Stellenbosch Univ, Desmond Tutu TB Ctr, Dept Paediat & Child Hlth, Cape Town, South Africa
[19] TB Proof, Cape Town, South Africa
[20] Francis Crick Inst, London, England
[21] London Sch Hyg & Trop Med, TB Ctr, TB Modelling Grp, London, England
[22] London Sch Hyg & Trop Med, Dept Infect Dis Epidemiol, London, England
[23] MRC Clin Trials Unit UCL, 90 High Holborn, London WC1V 6LJ, England
基金
英国医学研究理事会; 比尔及梅琳达.盖茨基金会; 欧洲研究理事会;
关键词
MYCOBACTERIUM-TUBERCULOSIS; PULMONARY TUBERCULOSIS; TRANSMISSION; STANDARDS; DISEASE; ADULTS;
D O I
10.1016/S2213-2600(24)00028-6
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The current active-latent paradigm of tuberculosis largely neglects the documented spectrum of disease. Inconsistency with regard to definitions, terminology, and diagnostic criteria for different tuberculosis states has limited the progress in research and product development that are needed to achieve tuberculosis elimination. We aimed to develop a new framework of classification for tuberculosis that accommodates key disease states but is sufficiently simple to support pragmatic research and implementation. Through an international Delphi exercise that involved 71 participants representing a wide range of disciplines, sectors, income settings, and geographies, consensus was reached on a set of conceptual states, related terminology, and research gaps. The International Consensus for Early TB (ICE-TB) framework distinguishes disease from infection by the presence of macroscopic pathology and defines two subclinical and two clinical tuberculosis states on the basis of reported symptoms or signs of tuberculosis, further differentiated by likely infectiousness. The presence of viable Mycobacterium tuberculosis and an associated host response are prerequisites for all states of infection and disease. Our framework provides a clear direction for tuberculosis research, which will, in time, improve tuberculosis clinical care and elimination policies.
引用
收藏
页码:484 / 498
页数:15
相关论文
共 67 条
[1]   Aerosol Sampling Outperforms Sputum to Predict Mycobacterium tuberculosis Transmission [J].
Acuna-Villaorduna, Carlos ;
Fennelly, Kevin P. ;
Jones-Lopez, Edward C. .
CLINICAL INFECTIOUS DISEASES, 2023, 77 (07) :1073-1073
[2]  
[Anonymous], 1981, TUBERCLE, V62, P155
[3]  
[Anonymous], 2021, WHO consolidated guidelines on tuberculosis: Module 1: Prevention-infection prevention and control
[4]  
[Anonymous], 1999, What is DOTS? A Guide to Understanding the WHO-recommended TB Control Strategy Known as DOTS
[5]   The spectrum of latent tuberculosis: rethinking the biology and intervention strategies [J].
Barry, Clifton E., III ;
Boshoff, Helena I. ;
Dartois, Veronique ;
Dick, Thomas ;
Ehrt, Sabine ;
Flynn, JoAnne ;
Schnappinger, Dirk ;
Wilkinson, Robert J. ;
Young, Douglas .
NATURE REVIEWS MICROBIOLOGY, 2009, 7 (12) :845-855
[6]   Transmission of Mycobacterium tuberculosis from patients smear-negative for acid-fast bacilli [J].
Behr, MA ;
Warren, SA ;
Salamon, H ;
Hopewell, PC ;
de Leon, AP ;
Daley, CL ;
Small, PM .
LANCET, 1999, 353 (9151) :444-449
[7]   Is Mycobacterium tuberculosis infection life long? [J].
Behr, Marcel A. ;
Edelstein, Paul H. ;
Ramakrishnan, Lalita .
BMJ-BRITISH MEDICAL JOURNAL, 2019, 367
[8]   Cancer risk in tuberculosis patients in a high endemic area [J].
Chen, Guang-Liang ;
Guo, Li ;
Yang, Shun'e ;
Ji, Dong-Mei .
BMC CANCER, 2021, 21 (01)
[9]   The association of atherosclerotic cardiovascular disease and statin use with inflammation and treatment outcomes in tuberculosis [J].
Chidambaram, Vignesh ;
Castillo, Jennie Ruelas ;
Kumar, Amudha ;
Wei, Justin ;
Wang, Siqing ;
Majella, Marie Gilbert ;
Gupte, Akshay ;
Wang, Jann-Yuan ;
Karakousis, Petros C. .
SCIENTIFIC REPORTS, 2021, 11 (01)
[10]   Out-of-Africa migration and Neolithic coexpansion of Mycobacterium tuberculosis with modern humans [J].
Comas, Inaki ;
Coscolla, Mireia ;
Luo, Tao ;
Borrell, Sonia ;
Holt, Kathryn E. ;
Kato-Maeda, Midori ;
Parkhill, Julian ;
Malla, Bijaya ;
Berg, Stefan ;
Thwaites, Guy ;
Yeboah-Manu, Dorothy ;
Bothamley, Graham ;
Mei, Jian ;
Wei, Lanhai ;
Bentley, Stephen ;
Harris, Simon R. ;
Niemann, Stefan ;
Diel, Roland ;
Aseffa, Abraham ;
Gao, Qian ;
Young, Douglas ;
Gagneux, Sebastien .
NATURE GENETICS, 2013, 45 (10) :1176-U311