Knowledge gaps and research priorities for understanding the transmission of Mycobacterium tuberculosis and other airborne infections

Authors

  • J. Peter Cegielski Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
  • Sevim Ahmedov Bureau for Global Health, TB Division, USAID, Washington, DC, USA
  • Jun Cheng Chinese Center for Disease Control and Prevention, Beijing, China
  • Collin Dubick Department of Pediatric Infectious Diseases, Emory University, Atlanta, GA, USA
  • Emily Evans Division of Infectious Diseases, Emory University, Atlanta, GA, USA
  • Paul A. Jensen End TB Transmission Initiative, Stop TB Partnership, Geneva, Switzerland
  • Avinash Kanchar TB Prevention, Treatment, Care & Innovation Unit, Global Programme on Tuberculosis & Lung Health, World Health Organization, Geneva, Switzerland
  • Anita Rani Kansal National Institute of TB and Respiratory Diseases, New Delhi, India
  • Che-Chi Lin Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
  • Yuhong Liu Beijing Chest Hospital, Capital Medical University, Beijing, China
  • Michael Marll Department of Medicine, Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Emory University, Atlanta, GA, USA
  • Gyanshankar Mishra Department of Respiratory Medicine, Indira Gandhi Government Medical College, Nagpur, India
  • Matsie Mphahlele The Aurum Institute, Parktown, South Africa
  • Edward Nardell Division of Global Health Equity, Brigham and Woman’s Hospital, Harvard Medical School, Boston, MA, USA
  • Jako-Albert Nice Department Architecture and Industrial Design, Tshwane University of Technology, Pretoria, GAU, RSA
  • Jerod N. Scholten Division of TB Elimination and Innovation, KNCV Tuberculosis Foundation, The Hague, The Netherlands
  • Carrie Tudor Johns Hopkins University School of Nursing, Baltimore, MD, USA
  • Martie van der Walt Independent Consultant, Pretoria, South Africa
  • Helene Mari van der Westhuizen Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
  • Varvara Vauhkonen Independent Consultant, Helsinki, Finland
  • Richard L. Vincent Icahn School of Medicine, Mount Sinai, New York, NY, USA
  • Grigory Volchenkov Independent Consultant, Vladimir, Russia

DOI:

https://doi.org/10.3396/ijic.v21.23851

Keywords:

tuberculosis, SARS-CoV-2, COVID-19, airborne infections, airborne transmission, infectious aerosols, infection prevention and control

Abstract

Despite 5 years of SARS-CoV-2 research, as well as decades of research on tuberculosis (TB), large gaps remain in understanding the transmission of airborne pathogens. Our aim was to delineate these gaps. Understanding them would enable evidence-based, practical efforts to reduce transmission. Building upon the 2017 Roadmap for TB Transmission Science, we interviewed experts in the field and identified six salient topics harboring holes in knowledge that impede prevention and control efforts. These include 1) fundamental elements of aerobiology, 2) detecting and measuring infectious respiratory particles directly in the air, 3) the infectiousness of asymptomatic TB (by extension, other lung infections) and 4) of calm tidal breathing – including their contributions to global epidemiology, 5) the role of ‘superspreading’ in disease incidence, and 6) the duration of infectiousness of highly drug-resistant TB treated with the newest, all-oral short-course regimens. Based on an extensive literature review, we update advances in science since 2017 and then summarize knowledge gaps and research priorities. Several recent systematic reviews all noted the relatively low quality of published research, so there is an overriding need for high-quality studies to provide evidence for national and international entities upon which to base recommendations, guidelines, and standards.

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Published

2025-10-13

How to Cite

Cegielski, J. P., Ahmedov, S., Cheng, J., Dubick, C., Evans, E., Jensen, P. A., … Volchenkov, G. (2025). Knowledge gaps and research priorities for understanding the transmission of Mycobacterium tuberculosis and other airborne infections. International Journal of Infection Control, 21. https://doi.org/10.3396/ijic.v21.23851

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