Trade-offs in diagnostic algorithm, population coverage, and duration of community screening for tuberculosis: A modelling study In a mathematical modelling study, Katherine Horton and colleagues assess different tuberculosis (TB) community screening approaches and their estimated effects on TB incidence and mortality over ten ...

In this mathematical modelling study, Katherine Horton & co assess #TB community screening approaches & their estimated effects on TB incidence & mortality, concluding that methods that capture both infectious & non-infectious TB are needed to achieve sustained case reductions🧪
plos.io/4tuD2SM

In our latest paper in @plosmedicine.org, we explore trade-offs in diagnostic algorithm, coverage, and duration of community screening for #TB, highlighting the importance of symptom-agnostic approaches and the need for strategies to sustain impact when screening ends.

plos.io/4tuD2SM

A year after my last day with @lshtm-tbmod.bsky.social my work on modelling the impact of increasing men's access to care and reducing excess risk of TB has gone live @commsmed.nature.com

www.nature.com/articles/s43...

New study led by @alexandra-richards.bsky.social.

Reducing men’s TB risk and improving treatment access could have big impacts on #TB incidence and deaths for men, women, and children.

www.nature.com/articles/s43...

@kchorton.bsky.social
@uofgshw.bsky.social
@lightontb.bsky.social

🗞️ Recent study with @lshtm-tbmod.bsky.social modelled the potential impact of funding cuts to TB #PublicHealth initiatives from international donors

Already implemented USAID cuts could cost $7.5 billion (USD) for healthcare systems & people living with TB

Read 🔽
www.lshtm.ac.uk/research/cen...

Our analysis of #TB exposure and transmission patterns is now in @pnas.org. @petedodd24.bsky.social and I found a majority of TB transmission globally is attributable to contact with adult men, while contributions to transmission by age are more variable across regions.
www.pnas.org/doi/10.1073/...

The international boycott of ChatGPT has absolutely exploded.

2.5M people have already joined, and this is just the beginning.

Go to quitgpt.org.
Cancel your subscription, delete your account.
And tell at least one person why.

My op-ed: www.theguardian.com/commentisfre...

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...

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...

8/ Huge thanks to my co-authors: @petedodd24.bsky.social, @hannahrickman.bsky.social, @cugartegil.bsky.social, @kchorton.bsky.social, and @reinhouben.bsky.social. Very happy to see this work finally out! @lshtm.bsky.social @tb-lshtm.bsky.social @lshtm-tbmod.bsky.social @cmmid-lshtm.bsky.social

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...

7/ In summary, we incorporate new insights that reflect the dynamic nature of TB to provide a medically actionable estimate of the global population harbouring viable Mtb infection (tinyurl.com/mtbinfection). We urgently need tools that detect viable Mtb rather than relying on immunoreactivity.

Table showing the number of individuals globally and by WHO region infected with viable Mycobacterium tuberculosis in 2022

6/ We observed substantial regional variability. Of all recent infections, over 87% were found in the three WHO regions of Southeast Asia, the Western Pacific, and Africa. At the country level, India, Indonesia, and China collectively accounted for about 50% of recent global Mtb infections.

Global map showing prevalence of recent viable Mycobacterium tuberculosis infection in 2022.

5/ We found that in 2022, 134 million people (95% UI: 104–171) were recently infected with Mtb, equating to 1.7% (95% UI: 1.3–2.2) of the global population. In total, 289 million people (95% UI: 242–343), or 3.7% of the global population, were estimated to harbour viable Mtb infection.

4/ We focused on recent infections, acknowledging that the highest risk of progression to disease occurs within two years of infection. By integrating these insights, our model generated estimates for 171 countries (covering 99.6% of the global population), all six WHO regions, and globally.

Reevaluating progression and pathways following Mycobacterium tuberculosis infection within the spectrum of tuberculosis | PNAS Traditional understanding of the risk of progression from Mycobacterium tuberculosis (Mtb) infection to tuberculosis (TB) overlooks diverse present...

3/ First, we adjusted annual infection risk (ARI) trends for immunoreactivity reversion and age-specific mixing to better capture the force of infection. Second, we incorporated self-clearance of Mtb and calibrated rates using simulated infection-to-disease pathways (tinyurl.com/tbpath).

The Global Burden of Latent Tuberculosis Infection: A Re-estimation Using Mathematical Modelling In this mathematical modelling study, Rein Houben and colleagues provide updated estimates of latent tuberculosis infection worldwide and its implications of this reservoir with respect to goals for e...

2/ One quarter of the world was estimated to have ‘latent’ TB infection (tinyurl.com/ltbinf), but this reflects immunoreactivity after exposure, not viable infection. Incorporating insights on reversion, age-specific mixing, and self-clearance, we provide estimates of viable Mtb infection.

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/📢 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

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

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

The most important news of the day. #TBSky

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...

New comment:

Tuberculosis and undernutrition: improving estimates to reinforce the policy imperative

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

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! 🦠💊

doi.org/10.1371/jour...

5 million of them are about research

A global analysis of patterns of tuberculosis exposure and transmission Tuberculosis (TB) is a major public health concern and the leading infectious cause of mortality globally. The disease exhibits strong prevalence patterns by age and sex, but the implications of these...

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

Do no harm - re-evaluating the risks of overtreatment in community-wide tuberculosis screening Background Community-wide screening is a crucial strategy to end tuberculosis (TB), but a common concern is potential harm from overtreatment following false positive diagnoses. However, current refer...

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...

A plot, facetted by country, showing the percentage of TB that is urban and rural between 2000-2023

A forest plot, showing estimates of the urban to rural TB prevalence in 46 studies

Are there more people with #TB in cities or rural areas?

In a 🚨new🚨 preprint (NOT PEER REVIEWED) we modelled urban-rural TB trends from 2000-2023 in 26 countries with 4.6 billion people.

www.medrxiv.org/content/10.1...

Our systematic review of rural/urban differences in #TB prevalence shows evidence of rapidly urbanising epidemics in many settings, with differences across countries and regions.

Link to preprint below ⬇️

1/ It’s been 10 years (😮) since we reported that #TB prevalence was twice as high in men as in women.

📢 Our new preprint explores how sex differences have shifted with more recent national prevalence surveys and growing attention to #gender responsive TB prevention and care.

bit.ly/4gqP1LH

Still trying to figure out what MAHA hates more: women or vaccines.