Evidence map›Paper›PMID 38527485›Full record

ReviewThe Lancet. Respiratory medicine2024

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

Anna K Coussens, Syed M A Zaidi, Brian W Allwood, Puneet K Dewan, Glenda Gray, Mikashmi Kohli, Tamara Kredo, Ben J Marais, Guy B Marks, Leo Martinez and 9 more

Abstract readReviewConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Review in The Lancet. Respiratory medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 95 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
95citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

95 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Prevalence and Predictors of Tuberculosis in Adults and Adolescents With Sputum Trace Ultra Results in 2 High-Burden Clinical Settings.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
    Article
  9. Article
  10. Breaking barriers: Implementation of a tuberculosis preventive treatment protocol among newly eligible populations with promising results.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026
    Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Review
  16. Asymptomatic Tuberculosis in Children With Household Exposure to Mycobacterium tuberculosis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026
    Article
  17. Article
  18. Article
  19. Observational
  20. Article

35 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Anna K CoussensInfectious Diseases and Immune Defence Division, The Walter and Eliza Hall Institute of Medical Research (WEHI), Parkville, VIC, Australia; Centre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town, South Africa; Institute of Infectious Disease and Molecular Medicine, and Department of Pathology, University of Cape Town, Cape Town, South Africa; Department of Medical Biology, University of Melbourne, Parkville, VIC, Australia.
Syed M A ZaidiWHO Collaborating Centre on Tuberculosis Research and Innovation, Institute for Global Health, and MRC Clinical Trials Unit, University College London, London, UK; Department of Public Health, National University of Medical Sciences, Rawalpindi, Pakistan.
Brian W AllwoodDivision of Pulmonology, Department of Medicine, Stellenbosch University, Stellenbosch, South Africa.
Puneet K DewanTuberculosis and HIV, Bill & Melinda Gates Foundation, Seattle, WA, USA.
Glenda GrayHealth Systems Research Unit, South Africa Medical Research Council, Cape Town, South Africa.
Mikashmi KohliHealth Programmes, FIND, Geneva, Switzerland.
Tamara KredoHealth Systems Research Unit, South Africa Medical Research Council, Cape Town, South Africa.
Ben J MaraisSydney Infectious Diseases Institute, University of Sydney, Sydney, NSW, Australia; WHO Collaborating Centre in Tuberculosis, University of Sydney, Sydney, NSW, Australia.
Guy B MarksDepartment of Clinical Medicine, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
Leo MartinezDepartment of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
Morten RuhwaldHealth Programmes, FIND, Geneva, Switzerland.
Thomas J ScribaCentre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town, South Africa; South African Tuberculosis Vaccine Initiative, University of Cape Town, Cape Town, South Africa; Institute of Infectious Disease and Molecular Medicine, and Department of Pathology, University of Cape Town, Cape Town, South Africa.
James A SeddonDepartment of Infectious Disease, Imperial College London, London, UK; Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Stellenbosch University, Cape Town, South Africa.
Phumeza TisileTB Proof, Cape Town, South Africa.
Digby F WarnerCentre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town, South Africa; Institute of Infectious Disease and Molecular Medicine, and Department of Pathology, University of Cape Town, Cape Town, South Africa.
Robert J WilkinsonCentre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town, South Africa; Department of Infectious Disease, Imperial College London, London, UK; The Francis Crick Institute, London, UK.
Hanif EsmailCentre for Infectious Diseases Research in Africa, University of Cape Town, Cape Town, South Africa; WHO Collaborating Centre on Tuberculosis Research and Innovation, Institute for Global Health, and MRC Clinical Trials Unit, University College London, London, UK. Electronic address: h.esmail@ucl.ac.uk.
Rein M G J HoubenTB Modelling Group, TB Centre, and Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
International Consensus for Early TB (ICE-TB) group

Funding

Aurum Clinical Trials UnitUM1AI154463 · NIAID · AURUM INSTITUTE NPC · PI Gavin John Churchyard · 2021 to 2026
$8.1M
NIAID NIH HHS UM1 AI154463Wellcome Trust
6 · The paper itself

Abstract

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.

Indexed as

Delphi TechniqueTuberculosisHumansMycobacterium tuberculosis

Identifiers

PMID38527485
PMCPMC7616323

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.