TB or not TB? That is the question

"Since nobody knows the true number of TB patients, Nicolas Menzies a co-author on the paper and an associate professor of global health at the Harvard T.H. Chan School of Public Health says he and his colleagues used data on the number of TB cases submitted to the World Health Organization and came up with a formula to estimate false negatives and false positives."

"Menzies and his colleagues estimate that, of those who seek medical care for symptoms that could indicate a TB infection, about a million people have the disease but aren't given that diagnosis. They are false negatives. On the flip side, the estimated number of false positives was even worse: Two million or more people each year are erroneously told they have TB when they actually have something else."

""Amongst all of those individuals who are diagnosed and treated for TB every year, perhaps a quarter of them and maybe even higher might not have TB disease," Menzies says. He says, in the most serious cases, these patients could have a potentially fatal disease like pneumonia, lung cancer or chronic obstructive pulmonary disease. He says this type of misdiagnosis has been a "blind spot" in the TB world."

Tuberculosis returned to being the world's top infectious disease killer, causing 1.23 million deaths in 2024 and sickening about 10 million people each year. Data from 111 low- and middle-income countries and WHO case reports were used to estimate diagnostic errors and their scale. The estimates indicate about one million symptomatic care-seeking people with TB are not diagnosed (false negatives) and two million or more people are incorrectly diagnosed with TB (false positives) each year. Around a quarter or more of treated patients may not have TB, risking delayed treatment for serious conditions like pneumonia, lung cancer, or COPD. Improving diagnostic accuracy in TB programs is essential for patient care and public health.

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