NEW DELHI: A sweeping tuberculosis screening effort across the Northeast has uncovered a troubling reality: more than one-third of the TB cases detected among vulnerable populations showed no symptoms at all. The finding highlights the challenge of identifying “silent” infections that often go unnoticed until they are picked up through active screening.Health Ministry’s Annual Report 2025-26 shows that, during January-October 2025, 14,356 of the 41,727 TB cases detected among vulnerable populations under the National Tuberculosis Elimination Programme (NTEP) in the Northeast — about 34% — were asymptomatic, meaning the 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 the eight Northeastern states. Nearly 5.96 lakh people underwent chest X-ray screening, helping health authorities detect infections that might otherwise have remained hidden.Assam accounted for the largest share of asymptomatic TB cases, reporting 10,362 such patients, followed by Meghalaya (1,055), Nagaland (857) and Tripura (510). Arunachal Pradesh reported 479 asymptomatic cases, Manipur 465, Sikkim 380 and Mizoram 248.The data highlights the growing shift from passive diagnosis to active case-finding as India pushes towards its goal of eliminating tuberculosis. Public health experts say 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.More than 10.7 lakh presumptive TB patients were screened till Sept 2025 in the region, while 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.The aggressive screening strategy is also translating into 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%, while 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.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, while Nagaland and Arunachal Pradesh are using AI-assisted screening approaches in community settings.