@article{Sossen2023a,
abstract = {Stages of tuberculosis disease can be delineated by radiology, microbiology, and symptoms, but transitions between these stages remain unclear. In a systematic review and meta-analysis of studies of individuals with untreated tuberculosis who underwent follow-up (34 cohorts from 24 studies, with a combined sample of 139 063), we aimed to quantify progression and regression across the tuberculosis disease spectrum by extracting summary estimates to align with disease transitions in a conceptual framework of the natural history of tuberculosis. Progression from microbiologically negative to positive disease (based on smear or culture tests) in participants with baseline radiographic evidence of tuberculosis occurred at an annualised rate of 10{\%} (95{\%} CI 6{\textperiodcentered}2–13{\textperiodcentered}3) in those with chest x-rays suggestive of active tuberculosis, and at a rate of 1{\%} (0{\textperiodcentered}3–1{\textperiodcentered}8) in those with chest x-ray changes suggestive of inactive tuberculosis. Reversion from microbiologically positive to undetectable disease in prospective cohorts occurred at an annualised rate of 12{\%} (6{\textperiodcentered}8–18{\textperiodcentered}0). A better understanding of the natural history of pulmonary tuberculosis, including the risk of progression in relation to radiological findings, could improve estimates of the global disease burden and inform the development of clinical guidelines and policies for treatment and prevention},
author = {Sossen, Bianca and Richards, Alexandra S and Heinsohn, Torben and Frascella, Beatrice and Balzarini, Federica and Oradini-Alacreu, Aurea and Odone, Anna and Rogozinska, Ewelina and H{\"{a}}cker, Brit and Cobelens, Frank and Kranzer, Katharina and Houben, Rein M G J and Esmail, Hanif},
doi = {10.1016/S2213-2600(23)00097-8},
file = {:C$\backslash$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Sossen et al. - 2023 - The natural history of untreated pulmonary tuberculosis in adults a systematic review and meta-analysis.pdf:pdf},
issn = {2213-2600},
journal = {The Lancet Respiratory Medicine},
keywords = {fund{\_}not{\_}ack,review},
mendeley-tags = {fund{\_}not{\_}ack,review},
month = {mar},
pages = {https://doi.org/10.1016/ S2213--2600(23)00097--8},
pmid = {36966795},
publisher = {Elsevier},
title = {{The natural history of untreated pulmonary tuberculosis in adults: a systematic review and meta-analysis}},
url = {https://linkinghub.elsevier.com/retrieve/pii/S2213260023000978},
year = {2023}
}

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In a systematic review and meta-analysis of studies of individuals with untreated tuberculosis who underwent follow-up (34 cohorts from 24 studies, with a combined sample of 139 063), we aimed to quantify progression and regression across the tuberculosis disease spectrum by extracting summary estimates to align with disease transitions in a conceptual framework of the natural history of tuberculosis. Progression from microbiologically negative to positive disease (based on smear or culture tests) in participants with baseline radiographic evidence of tuberculosis occurred at an annualised rate of 10% (95% CI 6˙2–13˙3) in those with chest x-rays suggestive of active tuberculosis, and at a rate of 1% (0˙3–1˙8) in those with chest x-ray changes suggestive of inactive tuberculosis. Reversion from microbiologically positive to undetectable disease in prospective cohorts occurred at an annualised rate of 12% (6˙8–18˙0). A better understanding of the natural history of pulmonary tuberculosis, including the risk of progression in relation to radiological findings, could improve estimates of the global disease burden and inform the development of clinical guidelines and policies for treatment and prevention","author":[{"propositions":[],"lastnames":["Sossen"],"firstnames":["Bianca"],"suffixes":[]},{"propositions":[],"lastnames":["Richards"],"firstnames":["Alexandra","S"],"suffixes":[]},{"propositions":[],"lastnames":["Heinsohn"],"firstnames":["Torben"],"suffixes":[]},{"propositions":[],"lastnames":["Frascella"],"firstnames":["Beatrice"],"suffixes":[]},{"propositions":[],"lastnames":["Balzarini"],"firstnames":["Federica"],"suffixes":[]},{"propositions":[],"lastnames":["Oradini-Alacreu"],"firstnames":["Aurea"],"suffixes":[]},{"propositions":[],"lastnames":["Odone"],"firstnames":["Anna"],"suffixes":[]},{"propositions":[],"lastnames":["Rogozinska"],"firstnames":["Ewelina"],"suffixes":[]},{"propositions":[],"lastnames":["Häcker"],"firstnames":["Brit"],"suffixes":[]},{"propositions":[],"lastnames":["Cobelens"],"firstnames":["Frank"],"suffixes":[]},{"propositions":[],"lastnames":["Kranzer"],"firstnames":["Katharina"],"suffixes":[]},{"propositions":[],"lastnames":["Houben"],"firstnames":["Rein","M","G","J"],"suffixes":[]},{"propositions":[],"lastnames":["Esmail"],"firstnames":["Hanif"],"suffixes":[]}],"doi":"10.1016/S2213-2600(23)00097-8","file":":C$\\$:/Users/01462563/AppData/Local/Mendeley Ltd./Mendeley Desktop/Downloaded/Sossen et al. - 2023 - The natural history of untreated pulmonary tuberculosis in adults a systematic review and meta-analysis.pdf:pdf","issn":"2213-2600","journal":"The Lancet Respiratory Medicine","keywords":"fund_not_ack,review","mendeley-tags":"fund_not_ack,review","month":"mar","pages":"https://doi.org/10.1016/ S2213–2600(23)00097–8","pmid":"36966795","publisher":"Elsevier","title":"The natural history of untreated pulmonary tuberculosis in adults: a systematic review and meta-analysis","url":"https://linkinghub.elsevier.com/retrieve/pii/S2213260023000978","year":"2023","bibtex":"@article{Sossen2023a,\r\nabstract = {Stages of tuberculosis disease can be delineated by radiology, microbiology, and symptoms, but transitions between these stages remain unclear. In a systematic review and meta-analysis of studies of individuals with untreated tuberculosis who underwent follow-up (34 cohorts from 24 studies, with a combined sample of 139 063), we aimed to quantify progression and regression across the tuberculosis disease spectrum by extracting summary estimates to align with disease transitions in a conceptual framework of the natural history of tuberculosis. Progression from microbiologically negative to positive disease (based on smear or culture tests) in participants with baseline radiographic evidence of tuberculosis occurred at an annualised rate of 10{\\%} (95{\\%} CI 6{\\textperiodcentered}2–13{\\textperiodcentered}3) in those with chest x-rays suggestive of active tuberculosis, and at a rate of 1{\\%} (0{\\textperiodcentered}3–1{\\textperiodcentered}8) in those with chest x-ray changes suggestive of inactive tuberculosis. Reversion from microbiologically positive to undetectable disease in prospective cohorts occurred at an annualised rate of 12{\\%} (6{\\textperiodcentered}8–18{\\textperiodcentered}0). 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