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Kate LeGrand

@lekate

PhD candidate with the LSHTM TB Modelling Group | Geospatial epi, med anthro, and community-based research

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17.11.2024
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Latest posts by Kate LeGrand @lekate

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The potential impact of reduced international donor funding on the household economic burden of tuberculosis in low- and middle-income countries: A modeling study In a modelling 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 ...

With Nick Menzies and @lshtm-tbmod.bsky.social, our new modeling study estimated how reductions in donor funding could affect the economic burden of #TB on patients, especially among the poorest households journals.plos.org/plosmedicine...

27.02.2026 21:16 πŸ‘ 5 πŸ” 5 πŸ’¬ 0 πŸ“Œ 1
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The potential impact of reduced international donor funding on the household economic burden of tuberculosis in low- and middle-income countries: A modeling study In a modelling 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 ...

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 πŸ§ͺ #MedSky #TB
plos.io/4ryyBFX

24.02.2026 10:37 πŸ‘ 16 πŸ” 15 πŸ’¬ 0 πŸ“Œ 2
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Estimating the population impact of new tuberculosis vaccines depending on efficacy against infectious asymptomatic tuberculosis: A modelling study Hira Tanvir and colleagues estimate the potential impact of new tuberculosis vaccines under three scenarios of efficacy and conclude that to achieve the greatest impact, vaccines must prevent asymptom...

Our recent modelling study found that the estimated impact of new TB vaccines depends on the efficacy to prevent infectious asymptomatic TB. Read more in our paper out now in @plosmedicine.org!

journals.plos.org/plosmedicine...

24.02.2026 14:46 πŸ‘ 15 πŸ” 13 πŸ’¬ 1 πŸ“Œ 0
The effects of war on digital adherence technology engagement for TB treatment in Ukraine SUMMARYBACKGROUNDThe Russian invasion of Ukraine in February 2022 has disrupted TB care. We examine the effects of the war on people with drug-susceptible TB (PWTB) and health care worker (HCW) engagement with a digital adherence technology (DAT).METHODSWe conducted a cluster-randomised trial of a DAT intervention in Ukraine. In the intervention arm, PWTB received a pillbox with a daily treatment reminder. Pillbox openings were captured real-time onto a platform, accessed by HCWs who could add manual doses where relevant. We compared DAT engagement in pre-, early-, and later-war periods.RESULTSFrom June 2021 to 2022, 816 PWTB (32% women, median age 44 years) were enrolled. DAT engagement varied across regions and time period, with a decline in engagement post-February 2022. PWTB DAT engagement was 78%–84% of treatment-days. There was a three- to four-fold increase in unknown dose or delays in manual reporting of adherence (>7 days) post-February 2022 versus pre-war in Mykolaivska and Donetska oblasts and a two-fold increase in Odeska, Lvivska, and Zakarpatska oblasts.CONCLUSIONThe war significantly disrupted DAT engagement, particularly in regions heavily affected by the conflict. Reduced engagement was likely due to migration and communication challenges. There is a critical need for resilient TB care in conflict settings.

We know conflict & crises have severe repercussions for TB; health system disruptions, displacement, food insecurity... In our latest paper we examine the effects of war in Ukraine on engagement with a digital adherence tech by people w TB & health care workers journals.theunion.org/content/ijtl...

16.02.2026 09:26 πŸ‘ 10 πŸ” 8 πŸ’¬ 1 πŸ“Œ 0
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Estimating the global burden of viable Mycobacterium tuberculosis infection: A mathematical modelling study Alvaro Schwalb and colleagues conducted a mathematical modelling study to estimate the global burden of viable Mycobacterium tuberculosis--that which can cause disease and be transmitted--to help guid...

1/πŸ“’ 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

13.02.2026 11:39 πŸ‘ 37 πŸ” 25 πŸ’¬ 2 πŸ“Œ 2
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Estimating the global burden of viable Mycobacterium tuberculosis infection: A mathematical modelling study Alvaro Schwalb and colleagues conducted a mathematical modelling study to estimate the global burden of viable Mycobacterium tuberculosis--that which can cause disease and be transmitted--to help guid...

In this mathematical modeling study, Alvaro Schwalb and colleagues estimate the global burden of viable Mycobacterium tuberculosisβ€”that which can cause disease and be transmittedβ€”to help guide disease prevention efforts πŸ§ͺ #tuberculosis #MedSky
plos.io/4aqzIQV

09.02.2026 12:05 πŸ‘ 11 πŸ” 6 πŸ’¬ 0 πŸ“Œ 2
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Insights on the implementation strategies for a potential new tuberculosis vaccine in South Africa Several tuberculosis (TB) vaccines intended for adults and adolescents are in late-stage clinical trials, but there is limited research into how a new TB vaccine would be introduced. South Africa is a...

Our new paper on strategies for implementing a potential new #TB #vaccine in South Africa is now published in @plosglobalpublichealth.org!

doi.org/10.1371/jour...

04.02.2026 17:06 πŸ‘ 7 πŸ” 10 πŸ’¬ 1 πŸ“Œ 0

The TBMAC intro course is always a highlight of #UnionConf, and I loved being a tutor this year! We equipped a new audience with a clear understanding of how TB models are set up and what they can do to drive policy #EndTB #WCLH2025 #GlobalHealth

25.11.2025 15:27 πŸ‘ 4 πŸ” 0 πŸ’¬ 0 πŸ“Œ 0

Interested in #TB, equity, and modelling? @reinhouben.bsky.social and I are advertising an MRC LID studentship on heterogeneity in the coverage of community screening for TB @lshtm-tbmod.bsky.social @lshtm.bsky.social.

For more details, visit mrc-lid.lshtm.ac.uk/2026-27-proj...

11.11.2025 08:27 πŸ‘ 3 πŸ” 4 πŸ’¬ 0 πŸ“Œ 1
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What’s a #UnionConf without the TB modelling course? Packed room again for a long day of intro to modelling.
@lshtm-tbmod.bsky.social @tb-mac.bsky.social #WCLH2025 #TBSky

18.11.2025 10:28 πŸ‘ 17 πŸ” 5 πŸ’¬ 1 πŸ“Œ 1
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Information for applicants - MRC London Intercollegiate Doctoral Training Partnership Studentships MRC LID studentship information for applicants How to Apply Projects Studentship funding Studentship options Studentship...

@lshtm-tbmod.bsky.social is offering multiple PhD opportunities through MRC LID, deadline 14 Jan. More details: mrc-lid.lshtm.ac.uk/applicants/
Projects include
#1 TB & screening
#2 TB & climate change
#3 TB & vaccines
#4 TB & influenza
#5 TB & prevention
@cmmid-lshtm.bsky.social @lshtm.bsky.social

18.11.2025 14:49 πŸ‘ 7 πŸ” 7 πŸ’¬ 1 πŸ“Œ 1
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Perhaps the most important collaboration at #UnionConf2025?

WHO STOP TB’s Hello Kitty met the LSHTM TB Modelling Group’s bunny mascot β€œBugs” today 🐰

Shout out to @stoptb.bsky.social and @lshtm-tbmod.bsky.social for making TB epidemiology both rigorous and accessible. #EndTB #WCLH2025

18.11.2025 10:20 πŸ‘ 9 πŸ” 2 πŸ’¬ 0 πŸ“Œ 1
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The keynote of #UnionConf2025 reminded us why we’re all here.
Author @johngreensbluesky.bsky.social & TB survivor Henry Rider delivered an impassioned call to action, centering lived experiences and fairness as drivers of new research.

This week is about science AND solidarity #EndTB #WCLH2025

18.11.2025 09:50 πŸ‘ 2 πŸ” 0 πŸ’¬ 0 πŸ“Œ 0

Come join the @lshtm-tbmod.bsky.social for a PhD!

11.11.2025 15:10 πŸ‘ 1 πŸ” 0 πŸ’¬ 0 πŸ“Œ 0
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Climate change and tuberculosis: an analytical framework Climate change is likely to exacerbate a range of determinants that drive tuberculosis, the world's leading cause of death from a single infectious agent. However, tuberculosis is often neglected in w...

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...

31.10.2025 09:12 πŸ‘ 22 πŸ” 18 πŸ’¬ 1 πŸ“Œ 0
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Tuberculosis and undernutrition: improving estimates to reinforce the policy imperative Undernutrition is a key driver of the global tuberculosis epidemic, increasing the risk of people developing tuberculosis disease and of poor outcomes in those who do.1 Each year, WHO publishes estima...

β€œWow, 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...

28.10.2025 09:44 πŸ‘ 8 πŸ” 10 πŸ’¬ 1 πŸ“Œ 1
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Impact of fluoroquinolone resistance on the cost-effectiveness of empiric treatment for multidrug- or rifampicin-resistant tuberculosis The WHO recommends the bedaquiline, pretomanid, and linezolid (BPaL) regimen with the additional fluoroquinolone antibiotic moxifloxacin (BPaLM) for initial treatment of multidrug- or rifampicin-resis...

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! πŸ¦ πŸ’Š

doi.org/10.1371/jour...

20.10.2025 18:47 πŸ‘ 12 πŸ” 12 πŸ’¬ 1 πŸ“Œ 0
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Body mass index and tuberculosis risk: an updated systematic literature review and dose–response meta-analysis AbstractBackground. The relationship between nutritional status and tuberculosis is critically important but poorly understood. We extended a 2009 review c

Nutritional status is a key determinant of TB. In this updated systematic review and dose-response meta-analysis (43 cohorts inc > 26 million people) we redefined the relationship between body mass index (BMI) and TB. doi.org/10.1093/ije/...

09.09.2025 08:35 πŸ‘ 9 πŸ” 9 πŸ’¬ 2 πŸ“Œ 1
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The potential impact, cost and cost-effectiveness of tuberculosis interventions - a modelling exercise Background While a range of interventions exist for tuberculosis prevention, screening, diagnosis, and treatment, their potential population impact and cost-effectiveness are seldom directly compared,...

At a time when global resources for #TB research, development, prevention, and care are limited, which interventions should be prioritised in high burden settings?

πŸ“’ Our new pre-print compares the impact, cost, and cost-effectiveness of 9 TB interventions in 3 countries. 1/n

bit.ly/3V3vXth

05.09.2025 10:05 πŸ‘ 11 πŸ” 9 πŸ’¬ 1 πŸ“Œ 0

πŸ“― New research from @kchorton.bsky.social and colleagues from @lshtm-tbmod.bsky.social!

#TB incidence can rebound after community screening ends, meaning the gains made during a program can be erased in the years that follow. This highlights a major challenge in sustaining impact #EndTB #EpiSky

02.09.2025 14:27 πŸ‘ 4 πŸ” 1 πŸ’¬ 0 πŸ“Œ 0
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Scientists’ role in defending democracy The United States’ democratic leadership, commitment to freedom of expression, and investment in the pursuit of knowledge have long enabled its preeminence in science and technology. Yet today we are ...

Scientists’ role in defending democracy

www.science.org/doi/10.1126/...

14.08.2025 19:08 πŸ‘ 22 πŸ” 15 πŸ’¬ 0 πŸ“Œ 0

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

14.07.2025 08:46 πŸ‘ 13 πŸ” 13 πŸ’¬ 0 πŸ“Œ 2
Within-country heterogeneity in patterns of social contact relevant for tuberculosis infection transmission, prevention, and care Mycobacterium tuberculosis (Mtb) transmission is driven by variable social, environmental, and biological factors, including the number and duration of indoor contacts. Social contact data can provide...

Our new study examines social contact patterns in urban, peri-urban, and rural communities and their implications for #TB interventions like household contact tracing, infection prevention, and cluster RCTs. #MedSky #EpiSky #IDsky #TBSky

Read more in @plosglobalpublichealth.org

15.07.2025 21:49 πŸ‘ 14 πŸ” 8 πŸ’¬ 0 πŸ“Œ 0
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11,000 more TB patients died after Trump's USAID cuts. That number will rise. | Opinion The potential for thousands of new deaths from TB is not worth the less than 1% in federal savings that came from cutting USAID.

Great op-ed @usatoday.com from longtime TB Fighter Quinn Yates: www.usatoday.com/story/opinio...

08.07.2025 13:19 πŸ‘ 539 πŸ” 104 πŸ’¬ 7 πŸ“Œ 5

New systematic review led by @hannahrickman.bsky.social shows annual risk of Mycobacterium #tuberculosis conversion in men and women diverges during adolescence and remains higher among men throughout adulthood.

www.thelancet.com/journals/lan...

02.07.2025 14:57 πŸ‘ 5 πŸ” 6 πŸ’¬ 0 πŸ“Œ 0
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.

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

04.07.2025 11:25 πŸ‘ 14 πŸ” 14 πŸ’¬ 3 πŸ“Œ 0
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Tuberculosis still kills around 1.3 million people every year.

It was once a massive killer in Europe and the US, but not anymore. How did these countries manage to tackle it?

Our first article on TB in a three-part series: ourworldindata.org/tuberculosis...

09.06.2025 06:17 πŸ‘ 76 πŸ” 23 πŸ’¬ 6 πŸ“Œ 0
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Tuberculosis and climate change: analytical framework and knowledge gaps This report explores the intersection of tuberculosis (TB) and climate change, highlighting how climate-related challenges such as food and water insecurity, displacement, and disrupted healthcare acc...

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...

30.05.2025 08:30 πŸ‘ 33 πŸ” 25 πŸ’¬ 1 πŸ“Œ 0
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25th anniversary celebrations of the Introduction to Infectious Disease Our special event will celebrate the 25th anniversary of the Introduction to Infectious Disease Modelling and its Applications course, delivered by the London School of Hygiene & Tropical Medicine

Can you believe it’s already been 25 years!?

Come join us on 20 June 2025 at 4pm UK time to celebrate the 25th anniversary of the Introduction to #Infectious Disease #Modelling course delivered by @lshtm.bsky.social and @ukhsa.bsky.social!

More info πŸ‘‰ www.lshtm.ac.uk/newsevents/e...

28.05.2025 10:39 πŸ‘ 8 πŸ” 7 πŸ’¬ 1 πŸ“Œ 3

The chest x-ray use pioneered by Alan Hart continues to be extremely important in screening for tuberculosis. Although no one accomplishes anything in isolation, I'd argue that Hart has helped saved MILLIONS of lives because chest x-rays have been so essential in driving down rates of TB globally.

02.06.2025 12:55 πŸ‘ 1119 πŸ” 187 πŸ’¬ 4 πŸ“Œ 3