[University of Cape Town] Asymptomatic TB: A Hidden Challenge for TB Control

30 July 2026

University of Cape Town news release

Asymptomatic TB is common and biologically more complex than previously understood, with implications for treatment and care strategies. This is according to University of Cape Town researchers, who have published new findings in Nature Communications that challenge current approaches to TB detection and control in South Africa.

South Africa carries one of the world’s heaviest burdens of TB. It has recently become clear that many people with active TB do not recognise or report typical symptoms such as a cough, fever or weight loss. Studies have shown that over half of all TB cases identified in national surveys are asymptomatic and some community screening initiatives in South Africa have found that more than 80% of people with TB are asymptomatic. Despite its prevalence, asymptomatic TB remains poorly understood from a biological perspective, and current diagnostic tools developed for symptomatic patients perform poorly when screening for asymptomatic disease in communities.

The most significant finding from this research is that asymptomatic TB is not a single disease entity. Using advanced transcriptomic (gene expression) and proteomic (protein) analysis of blood samples, researchers identified two distinct subtypes of asymptomatic TB with markedly different biological features and disease severity.

Read the full news release here.

Source: University of Cape Town