{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T01:58:15Z","timestamp":1785290295234,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Asymptomatic tuberculosis (TB) is emerging as a disease state warranting attention because it is presumed infectious, yet affected individuals lack symptoms. The World Health Organization recommends screening for cough, fever, weight loss and night sweats and recently defined asymptomatic TB. However, the place of these symptoms in the definition has not yet been standardised. We determined the proportion of patients with bacteriologically confirmed asymptomatic TB without four symptom definitions: persistent cough (&gt;\u20092\u2009weeks), cough of any duration, W4SS of any duration or W4SS for &gt;\u20092\u2009weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Secondary analysis of the Namibia TB prevalence survey data was performed; a representative sample had been interviewed for symptoms, underwent chest radiography and was offered bacteriological testing. The proportion of asymptomatic TB was computed for each definition. Logistic regression was used to determine factors associated with asymptomatic TB across four definitions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 29,495 participants in the nationally representative sample (86.8% of the target sample size), 123\u2009TB cases met the case definition. Mean age was 45\u2009years, and 74 (60%) were male. Of TB cases, 60\/123 (48.8%) reported a cough of any duration, 20\/123 (16.3%) a fever of any duration, 25\/123 (20.3%) weight loss and 26\/123 (21.1%) night sweats. Asymptomatic TB ranged from 39.8% to 63.0% by definition, with screening based on prolonged cough missing 63.0% of bacteriologically confirmed TB patients, while screening based on W4SS any duration missed 39.8% of TB cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Even when using an inclusive symptom screening system that includes any duration of the W4SS, asymptomatic TB occurred in 39.8%, highlighting a public health concern for asymptomatic TB. There is a need to standardise the symptoms being used when defining asymptomatic TB and we recommend the W4SS of any duration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.70206","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T01:00:27Z","timestamp":1785286827000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Asymptomatic Tuberculosis in the Namibia National Tuberculosis Prevalence Survey: Occurrence Under Various Case Definitions"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1764-3574","authenticated-orcid":false,"given":"Nunurai","family":"Ruswa","sequence":"first","affiliation":[{"name":"School of Medicine University of Namibia  Windhoek Namibia"},{"name":"National Tuberculosis and Leprosy Programme Ministry of Health and Social Services  Windhoek Namibia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunar","family":"Gunther","sequence":"additional","affiliation":[{"name":"School of Medicine University of Namibia  Windhoek Namibia"},{"name":"Department of Pulmonology, Allergology and Clinical Immunology Inselspital, Bern University Hospital, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farai","family":"Mavhunga","sequence":"additional","affiliation":[{"name":"World Health Organization  Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Cobelens","sequence":"additional","affiliation":[{"name":"Amsterdam University Medical Centres University of Amsterdam  Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5927-284X","authenticated-orcid":false,"given":"Mareli","family":"Claassens","sequence":"additional","affiliation":[{"name":"School of Medicine University of Namibia  Windhoek Namibia"},{"name":"Desmond Tutu TB Centre Stellenbosch University  Stellenbosch South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.54394\/CJQU6666","volume-title":"Global Tuberculosis Report 2024","author":"World Health Organization","year":"2024"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/CID\/CIAA1402"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3390\/tropicalmed5040185"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20102600(24)00028\u20106"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202110\u20102378OC"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.58699"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.82469"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciad027"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens11111228"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20102600(23)00097\u20108"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00021\u201018"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202101\u20100227LE"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202102\u20100367LE"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0208\u20102023"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1473\u20103099(21)00387\u2010x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0172881"},{"key":"e_1_2_10_18_1","volume-title":"Namibia TB Prevalence Survey Report 2019","author":"National Tuberculosis & Leprosy Programme","year":"2019"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473\u20103099(24)00011\u20102"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1093\/CID\/CIAB1050"},{"key":"e_1_2_10_21_1","volume-title":"National Guidelines for the Management of Tuberculosis","author":"MoHSS","year":"2012"},{"key":"e_1_2_10_22_1","volume-title":"Tuberculosis Prevalence Surveys: A Handbook [Internet]","author":"World Health Organization","year":"2011"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.19.0387"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102191"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879\u2010018\u20103614\u20107"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.14.04226"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1098519"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213\u20102600(24)00372\u20102"}],"container-title":["Tropical Medicine &amp; 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