A large-scale tuberculosis screening initiative across India's northeastern states has uncovered a concerning reality: more than one-third of TB cases detected among vulnerable populations showed no symptoms at all. This finding underscores the challenge of identifying silent infections that often go unnoticed until active screening brings them to light.
Asymptomatic Cases Dominate Detection
According to the Health Ministry's Annual Report 2025-26, between January and October 2025, 14,356 out of 41,727 TB cases detected among vulnerable groups under the National Tuberculosis Elimination Programme (NTEP) in the Northeast were asymptomatic. This accounts for approximately 34% of all cases, meaning these individuals were unlikely to have sought medical attention on their own.
The findings emerged from an intensive screening exercise that covered 39.04 lakh vulnerable individuals across all eight northeastern states. Nearly 5.96 lakh people underwent chest X-ray screening, helping health authorities detect infections that might otherwise have remained hidden.
State-wise Breakdown
Assam reported the highest number of asymptomatic TB cases, with 10,362 such patients. It was followed by Meghalaya (1,055), Nagaland (857), and Tripura (510). Arunachal Pradesh recorded 479 asymptomatic cases, Manipur 465, Sikkim 380, and Mizoram 248.
Shift from Passive to Active Case-Finding
The data highlights a growing shift from passive diagnosis to active case-finding as India pushes towards its goal of eliminating tuberculosis. Public health experts emphasize that asymptomatic patients pose a particular challenge because they often remain undetected for long periods, delaying treatment and increasing the risk of continued transmission within communities.
Screening and Diagnostic Infrastructure
More than 10.7 lakh presumptive TB patients were screened in the region by September 2025. The presumptive TB examination rate rose by 28%, from 2,062 per lakh population in 2024 to 2,645 per lakh in 2025. The region currently has 1,560 microscopy centres and 562 molecular testing facilities supporting TB diagnosis.
Treatment Outcomes and Progress
The aggressive screening strategy is translating into improved treatment outcomes. During 2025, the Northeast notified 62,123 TB cases, of which 57,213 patients (91%) were initiated on treatment. The region reported an overall treatment success rate of 89%. Additionally, 90% of patients had a known HIV status, and 84% underwent diabetes screening. More than 84% of patients also underwent rifampicin drug-susceptibility testing, strengthening efforts to detect drug-resistant TB early.
AI-Powered Screening Tools
Several northeastern states have begun deploying artificial intelligence-based screening tools to strengthen early detection. Meghalaya has introduced the Cough Against TB application and portable AI-enabled X-ray units. Nagaland and Arunachal Pradesh are using AI-assisted screening approaches in community settings.
This comprehensive approach aims to accelerate progress towards TB elimination by identifying and treating silent carriers of the disease.
