1/📢 In our new publication, we estimate that in 2022, 134 million people worldwide had a recent Mycobacterium tuberculosis (Mtb) infection and were at high risk of progressing to TB disease. Read the full paper in PLOS Medicine (tinyurl.com/mtbinfection). #TBSky
In this modeling study, Allison Portnoy and colleagues investigate the potential impact of reduced international donor funding on the household economic burden of tuberculosis in low- and middle-income countries 🧪 #MedSky #TB
plos.io/4ryyBFX
New comment:
Tuberculosis and undernutrition: improving estimates to reinforce the policy imperative
www.thelancet.com/journals/lan...
Our framework that informed the @who.int TB & climate change policy brief out now in @lancetrespirmed.bsky.social, exploring the intersections and implications of climate change for the TB epidemic. Key message? TB should be considered a climate-sensitive disease
www.thelancet.com/journals/lan...
very nice two-punch set of papers led by @mjsaunder.bsky.social and @cfmcquaid.bsky.social. First fix the many issues with recent reviews of BMI and TB, and then follow it through on the consequences for the key PAF metrics. Undernutrition was, is and remains a key driver of global TB burden.
“Wow, I saw in the last GTB report undernutrition is much less important for TB than we previously thought” I hear you say…
Well, no. We think this is an underestimate, & as much as 28% of TB could be attributable to undernutrition – see our latest comment here: www.thelancet.com/journals/lan...
When fluoroquinolone resistance status is unknown, empirical use of BPaLM (adding moxifloxacin to BPaL) is cost-effective as a replacement for BPaL even with high fluoroquinolone resistance levels! 🦠💊
doi.org/10.1371/jour...
Very important and helpful study, getting after the gap left by CXR and symptom pre-screening in disease prevalence surveys. Congrats @tomscriba.bsky.social and team on getting this done and through the publishing process.
Understanding patterns of #TB exposure and transmission is needed for targeted prevention strategies. In our latest pre-print, @petedodd24.bsky.social and I estimated the proportion of TB exposure to and transmission from sex and age groups for 177 countries.
bit.ly/4nbV492
Building on previous work led by Lara Veeken (doi.org/10.1093/infd...) who again contributed strongly to this work. Also @kchorton.bsky.social @aschwalbc.bsky.social , @danieljgrint.bsky.social and many others.
In a new preprint (NOT PEER REVIEWED) we continue to explore the challenge of overtreatment in community screening. It seems the benefits of TB treatment far outweigh the harms, especially once we accept that sputum culture is not perfect. Important food for thought. www.medrxiv.org/content/10.1...
Excellent work led by @aschwalbc.bsky.social, building on the trials by the ACT3 team @thuanhnguyen.bsky.social to show how investing in TB screening can save lives, and start to save money quickly. As TB continues to wreak havoc, we need to embrace bold solutions to make a real and lasting impact.
Finishing TB treatment isn’t the finish line. Our TB Champions are speaking out, showing why #PostTBCare needs urgent research. Their voices are the drivers of change. 💛 #EndTB #PostTB @posttbcare.bsky.social
Marvellous work led by @mjsaunder.bsky.social and @cfmcquaid.bsky.social to find more data and do better analyses to get to this crucial number. Now for WHO to update their PAF estimates, so we can follow up the measuring with better and properly prioritised managing.
Community screening for #tuberculosis could extend the reach of #TB services, but evidence on its effectiveness is limited.
In our latest preprint, we examine the epidemiological impact of trade-offs in diagnostic algorithm, population coverage, and duration of screening. 1/n
bit.ly/3UK7pFD
Our work estimating the potential impacts of reductions in international donor funding for #TB is now out in @lancetgh.bsky.social:
bit.ly/3TDl28T
@raclark18.bsky.social @cfmcquaid.bsky.social @alexandra-richards.bsky.social @top-j.bsky.social @reinhouben.bsky.social @richardwhite321.bsky.social
Figure 1. Estimated number of trial endpoints in the control group of a prevention-of-disease vaccine trial in a high disease-burden setting showing number of endpoints on the y-axis and time in months on the x-axis. For bacteriologically confirmed symptomatic tuberculosis disease endpoints only, we estimate 69 endpoints, and for combined bacteriologically confirmed asymptomatic and symptomatic tuberculosis disease endpoints, we estimate 151 endpoints. Scenario assumes symptomatic disease incidence before trial screening of 300/100 000 per year and following 10 000 individuals over 3 years. Prevalent symptomatic and asymptomatic tuberculosis disease are screened out in month 0 and are not trial endpoints. Active screening occurs every 6 months for both scenarios and participants self-presenting with symptoms suggestive of tuberculosis disease would also be investigated.
In our latest personal view in @lancetrespirmed.bsky.social, we argue for the inclusion asymptomatic #tuberculosis in vaccine trial endpoints to potentially reduce the size, length, and cost of trials.
doi.org/10.1016/S221...
@lshtm-tbmod.bsky.social @tb-lshtm.bsky.social
TB seems to comprehensively disrupt the normal physiological progression of puberty.
academic.oup.com/jid/advance-...
TB & climate change: @who.int report out now, building on an analytical framework we developed to explore the intersections and implications for the TB epidemic. Key message? TB should be considered a climate-sensitive disease www.who.int/publications...
So I'm not convinced that these are 'unimportant' positives. More likely there is an opportunity to interrupt or even prevent further health and livelihood costs for the individual, and transmission for the community. But v much agree that there is a lot to figure out. 3/3
... given that progression rates for bac neg TB are around 10%/y. I also don't think we know yet what level of short and long term damage untreated (and sometimes self-resolved) aTB causes, and how much of that would be prevented by providing Rx in some form. Again, should know more soon. 2/3
Good question(s) - we ^think^ that around 50% of asymptomatic bac pos TB progress to full blown 'classic' disease (so 50% do not). But this is v hard to pin down for obvious reasons (we're trying). Two other points to consider is that we do treat HHC, and their risk of sTB is likely lower... 1/3
Excellent work by @LaraVeeken (www.linkedin.com/in/lara-veek...), @aschwalbc.bsky.social @kchorton.bsky.social and wider Bandung team id.linkedin.com/in/raspati-c...,
id.linkedin.com/in/bachti-al...
Amid all the bad news in Global Health, perhaps some good news? A first analysis on the risk of false positive diagnoses in community-screening for tuberculosis using Xpert shows our clinic-based data is likely (very) wrong and overestimates false positives by >80%: tinyurl.com/yfecute9.
Are you interested in #TB and have experience in #modelling infectious diseases?
Come join us in the TB Modelling Group at #LSHTM!
We're advertising for a 1 year Research Fellow position, with a closing date of 30 May 2025 👉 jobs.lshtm.ac.uk/vacancy.aspx...
Climate-driven migration and displacement and their potential impact on TB in Latin America gh.bmj.com/content/10/4... @cfmcquaid.bsky.social @reinhouben.bsky.social @lshtm-tbmod.bsky.social
#Tuberculosis prevention and care relies heavily on international donor funding in many settings. In our latest preprint, we examine the potential impact of reductions in international donor funding for #TB - by the US and by other major donor countries. 1/8
www.medrxiv.org/content/10.1...
Thanks to co-authors on the #TB analysis @raclark18.bsky.social @cfmcquaid.bsky.social @alexandra-richards.bsky.social @reinhouben.bsky.social @richardwhite321.bsky.social and to John Stover at Avenir Health for pulling it all together.
@lshtm-tbmod.bsky.social @tb-lshtm.bsky.social
New preprint led by @alexandra-richards.bsky.social & @kchorton.bsky.social from @lightontb.bsky.social
Eliminating men’s excess risks for #TB & improving access to treatment to comparable rates to women could have major gains for men, women & children.
www.medrxiv.org/content/10.1...
Very nice analysis showing both potential and challenges of molepi in TB, having to work with samples from small fraction of TB episodes. Highly recommend the read, interesting data and thoughts for debate of targeted vs community-wide screening. But clearly a massive lift by the team, congrats!
