LSHTM TB Modelling Group

@lshtm-tbmod.bsky.social

Updates from the TB Modelling Group, a multidisciplinary group of mathematical modellers, economists, and epidemiologists from LSHTM

Poverty is a major driver of TB.Conditional cash transfers combined with counselling improve pre-treatment loss to follow-up.In this economic analysis our modelling projections show that this intervention is cost-effective and can reduce incidence and mortality. www.sciencedirect.com/science/arti...

Cost-effectiveness of conditional cash transfers with pre- and post-test tuberculosis counselling in South Africa: a modelling analysis

Tuberculosis (TB) disproportionately affects low-income populations due to socioeconomic barriers. Conditional cash transfers (CCTs) are promising str…

sciencedirect.com

It's been 10 years since we published our first review of sex differences in #TB prevalence. In this update, we found men remain twice as likely as women to have TB, and disparities have likely widened over time. journals.plos.org/plosmedicine...

Peter MacPherson@petermacp.bsky.social · 2mo ago

We updated our review of sex diff. in #TB prevalence In 102 surveys (4.7M participants) men were 2x as likely to have TB than women Evidence consistent with sex differences widening over time 🧪🛟 journals.plos.org/plosmedicine... @nswartwood.bsky.social @kchorton.bsky.social @uofgshw.bsky.social

A map showing countries where surveys were conducted. Bar chart shows the number of surveys per country

Key message: Eliminating undernutrition could prevent millions of people from developing TB. Scaling up nutritional interventions (which are likely to have myriad social and health benefits), particularly for populations in greatest need, should be an integral part of the global TB response.

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

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 ...

plos.io

First up is a modelling study by Hira Tanvir and colleagues, which estimates the potential impact of new #tuberculosis vaccines under three scenarios of efficacy, underscoring the need for TB vaccine trials to measure impact against asymptomatic disease🧪 #WorldImmunizationWeek plos.io/3Qw9MwK

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...

plos.io

PLOS Medicine@plosmedicine.org · 3mo ago

It's #WorldImmunizationWeek 💉this year's theme is "for every generation, vaccines work". This week we are amplifying this message by highlighting research & perspectives evaluating & demonstrating the efficacy, safety, cost-effectiveness & impact of #vaccines in protecting health & saving lives🧪

We found that #TB epidemics are becoming increasingly urbanised. Important implications for supporting effective public health interventions to end tuberculosis epidemics. 🧪 #MedSky @uofgshw.bsky.social @kchorton.bsky.social @nswartwood.bsky.social journals.plos.org/plosmedicine...

Graph of model predicted urban-to-rural TB prevalence between 2000 and 2024Graph showing predicted percentage of TB cases that were urban and rural between 2000 and 2024
PLOS Medicine@plosmedicine.org · 4mo ago

In this systematic review & meta-analysis, Mortazavi & colleagues (@petermacp.bsky.social) investigate urban vs rural differences in #TB prevalence between 2000 and 2024 in 26 low- and middle-income countries, finding that TB epidemics have become increasingly urbanized 🧪 #MedSky plos.io/3O79BqY

Great to see this work led by @alexandra-richards.bsky.social with @lightontb.bsky.social in @commsmed.nature.com. Further evidence that addressing gender disparities in TB burden and care are necessary for both an equitable response *and* an effective response. ⬇️

Peter MacPherson@petermacp.bsky.social · 4mo ago

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

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

PLOS Medicine@plosmedicine.org · 4mo ago

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

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/...

Bild
Katherine Horton@kchorton.bsky.social · 10mo ago

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

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...

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.

journals.theunion.org