“Innovation without access is injustice" - Brazilian Health Minister Dr Alexandre Padilha, at the AIDS conference in Rio Lenacapavir Tested in Brazil, Argentina, Peru.... Denied to these populations healthpolicy-watch.news/brazil-pushe...
Alvaro Schwalb
@aschwalbc.bsky.social
Infectious disease epidemiologist and TB mathematical modeller. Assistant Professor at LSHTM and Associate Researcher at IMTAvH. Tell your dog I said hi.
New publication led by Mphatso Phiri: Drivers of sex differences in Mycobacterium tuberculosis immunoreactivity among adolescents and adults in Blantyre, Malawi link.springer.com/article/10.1... @uofgshw.bsky.social @lightontb.bsky.social @kchorton.bsky.social #TB #Episky 🛟🧪
Drivers of sex differences in Mycobacterium tuberculosis immunoreactivity among adolescents and adults in Blantyre, Malawi - BMC Global and Public Health
Background Sex differences in Mycobacterium tuberculosis (Mtb) exposure likely contribute to sex differences in tuberculosis (TB) burden. However, population-level age- and sex-specific patterns of Mt...
link.springer.com
New preprint suggests that reported symptoms are not a reliable indicator of TB disease severity, and that the context in which someone is investigated for TB—self-presentation to a clinic vs active community screening—may be more informative 👇 medrxiv.org/content/10.64898/2026.07.10.26357755v1
medrxiv.org
Our new paper in @nathealth.nature.com shows that population-level #TB interventions are likely to have more meaningful impact on disease burden than interventions that only reach routinely diagnosed individuals or their households. www.nature.com/articles/s44... 1/7
Global impact and cost-effectiveness of tuberculosis interventions - Nature Health
A modelling analysis at a global scale estimates that three interventions (vaccination, community-wide screening and prison screening programmes) could prevent more than 10% of tuberculosis cases betw...
nature.com
New preprint suggests that combining clinic and community-based approaches is key to maximising the cost-effectiveness of #tuberculosis active case finding in South Africa 🇿🇦 Read more 👉 www.medrxiv.org/content/10.6...
Projected population level impact and cost-effectiveness of clinic and community-based tuberculosis screening approaches
The South Africa National Department of Health have set ambitious targets to scale up TB testing, focusing primarily on clinic attendees. In the context of declining funding for TB care and prevention...
medrxiv.org
Today, I'll be presenting our work on estimating the global burden of viable Mycobacterium tuberculosis infection at the Advanced TB Diagnostics course, part of the @mcgill.ca Summer Institutes in Global Health. I attended this course in 2019 and am very honoured to be among the speakers now!
New publication now out in @lancetgh.bsky.social! New #TB #vaccines are being trialled in older adolescents and adults, and we comment on the advantages and challenges of including younger adolescents who have historically been excluded. www.thelancet.com/journals/lan...
Inclusion of young adolescents in policy development for new tuberculosis vaccines
The infant tuberculosis vaccine, BCG, prevents severe tuberculosis disease, but protection is rarely durable beyond childhood. New tuberculosis vaccines are being developed for the prevention of infec...
thelancet.com
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
⚕️ A recent @tb-lshtm.bsky.social modelling study found that 134 million people were living with a recent Mycobacterium tuberculosis infection Centre member @aschwalbc.bsky.social wrote about these findings & their implications Read more 🔽 www.lshtm.ac.uk/research/cen...
So...what would happen to the global TB epidemic if we "eliminated" undernutrition? Our paper out now @lancetgh.bsky.social, where we combined estimates from our review (doi.org/10.1093/ije/...) with population-specific BMI distributions to find out...(www.sciencedirect.com/science/arti...)
Global, regional, and national estimates of tuberculosis incidence averted by eliminating undernutrition in adults: a modelling study
Current efforts to reduce global tuberculosis incidence have proved insufficient, highlighting that urgent action is needed to address underlying modi…
sciencedirect.com
![[Scene is the Tudor royal court. ladies and gentlemen standing round. In the corner a very fat HENRY VIII is hunched over playing a lute.]
1
LADY:
Hey Anne Boleyn -
Who’s that lute player?
ANNE BOLEYN:
I dunno
[Determined face]
But I’m gonna find out.
[Title lettering panel]:
THIS SUMMER
[Scene is now two musicians - one with a harp, the other is Henry VIII again playing the lute]
HARPIST:
Yo Henry VIII -
Who wrote that sick lute riff yo’ jamming?
HENRY VIII:
Why...
[Looking around, modest, surprised at the attention]
I did…!
[Title lettering panel]:
SEE THE STORY
[Scene is now a tudor record producer with ruff and wearing dark sunglasses]:
PRODUCER:
Congratulations Henry
Your lute thing is a hit and your story is now one of uncomplicated musical success!
[Show a panel with lots of Beatlemania-style scenes of success for Henry the musician - swooning tudor girls, playing lute on stage, waving to fans as he descends from his golden carriage. In the middle of it in Tudor lettering are the words]:
“UNCOMPLICATED MUSICAL SUCCESS MONTAGE”.
[Another scene - a man is saying to Henry]:
MAN:
Say Henry VIII -
Are you doing anything outside this narrative that is very bad or weird?
HENRY VIII:
No.
[Title lettering panel]:
…OF A MUSICAL GENIUS
who definitely didn’t do anything outside this narrative that was very bad or weird
[Scene with Thomas Cromwell]
THOMAS CROMWELL:
Hang on Henry aren't you also a -
HENRY VIII [jumping in front of him with his lute held aloft]:
LUTE SOLO!
[Final film title panel]:
HENRY VIII:
Rock Biopic
[rated U]
[Ends]](https://cdn.bsky.app/img/feed_thumbnail/plain/did:plc:4m3we4apbjayclzcnhwe3pfp/bafkreidmilghzmgnj35twr4xvnfm5eubpcdc4xmtd5nzexe2ybcubmeu7m)
Out now! Our preprint reviewing effects of extreme weather events on TB. papers.ssrn.com/sol3/papers.... @mjsaunder.bsky.social with Lauren Linde & Leo Martinez @bostonu.bsky.social & many others @tb-lshtm.bsky.social @lshtm-tbmod.bsky.social @lshtm-planet.bsky.social
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
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 agoIn 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
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...
Modelling the impact of increasing tuberculosis treatment coverage and addressing determinants of risk in men - Communications Medicine
Richards et al. use a compartmental transmission model of tuberculosis to understand the impact of strategies to improve men’s access to care and to reduce men’s excess risk of TB. In all four countri...
nature.com
The LIGHT Consortium @lightontb.bsky.social · 4mo agoWhat if targeting TB in men could benefit entire populations? This new modelling study from @alexandra-richards.bsky.social suggests exactly that 👇 ✔️ More treatment coverage ✔️ Address social & structural risks 👉 Big reductions in TB incidence & mortality 🔗 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
The LIGHT Consortium @lightontb.bsky.social · 4mo agoWhat if targeting TB in men could benefit entire populations? This new modelling study from @alexandra-richards.bsky.social suggests exactly that 👇 ✔️ More treatment coverage ✔️ Address social & structural risks 👉 Big reductions in TB incidence & mortality 🔗 www.nature.com/articles/s43...
🗞️ 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/...
Katherine Horton@kchorton.bsky.social · 10mo agoUnderstanding 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
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...
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...
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...
journals.plos.org
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
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
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...
tinyurl.com
@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
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...
mrc-lid.lshtm.ac.uk
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
Kate LeGrand@lekate.bsky.social · 9mo agoPerhaps the most important collaboration at #UnionConf2025? WHO STOP TB’s Hello Kitty met the LSHTM TB Modelling Group’s bunny mascot “Bugs” today 🐰 Shout out to @stoptb.bsky.social and @lshtm-tbmod.bsky.social for making TB epidemiology both rigorous and accessible. #EndTB #WCLH2025
New comment: Tuberculosis and undernutrition: improving estimates to reinforce the policy imperative www.thelancet.com/journals/lan...
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...
thelancet.com