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Rein Houben @reinhouben.bsky.social · 2d

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.

Mind the Clinic-Community Gap: Re-evaluation of Test Performance and False Positive Results in Community-Wide Tuberculosis Screening

This study shows that we likely overestimate the number of false positive tuberculosis diagnoses if clinic-based estimates of Xpert performance against cul

doi.org

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Rein Houben @reinhouben.bsky.social · 2d

In a new preprint (NOT PEER REVIEWED) we continue to explore the challenge of overtreatment in community screening.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...

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...

www.medrxiv.org

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Rein Houben @reinhouben.bsky.social · 28d

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.

Alvaro Schwalb @aschwalbc.bsky.social · 28d

Our work on modelling population-wide screening in Viet Nam is now available in PLOS Global Public Health! tinyurl.com/3ymhuj5s

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TB Proof @tbproof.bsky.social · 29d

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

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Rein Houben @reinhouben.bsky.social · Sep 9

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.

Matthew Saunders @mjsaunder.bsky.social · Sep 9

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/...

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

doi.org

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Reposted by Rein Houben

Katherine Horton @kchorton.bsky.social · Aug 27

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

Exploring trade-offs in diagnostic algorithm, population coverage, and duration of community screening for tuberculosis

Background Current tuberculosis (TB) prevention and care strategies have failed to reduce disease burden at the pace required to meet global targets. Community screening may enable more rapid declines...

www.medrxiv.org

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Reposted by Rein Houben

Katherine Horton @kchorton.bsky.social · Jul 14

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

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Katherine Horton @kchorton.bsky.social · Jul 4

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

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.

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James Seddon @jaseddon.bsky.social · Jun 3

TB seems to comprehensively disrupt the normal physiological progression of puberty.

academic.oup.com/jid/advance-...

Impact of puberty on immune responses to Mycobacterium tuberculosis in South African adolescents

AbstractBackground. As individuals progress through adolescence, their risk of tuberculosis (TB) increases and the type of disease that develops changes, w

academic.oup.com

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Reposted by Rein Houben

Finn McQuaid @cfmcquaid.bsky.social · May 30

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...

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...

www.who.int

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Rein Houben @reinhouben.bsky.social · May 28

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

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Rein Houben @reinhouben.bsky.social · May 28

... 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

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Rein Houben @reinhouben.bsky.social · May 28

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

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Rein Houben @reinhouben.bsky.social · May 27

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...

www.linkedin.com

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Rein Houben @reinhouben.bsky.social · May 27

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.

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LSHTM TB Modelling Group @lshtm-tbmod.bsky.social · May 16

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...

Job Opportunity at LSHTM: Research Fellow

The London School of Hygiene & Tropical Medicine (LSHTM) is a world-leading centre for research and postgraduate education in public and global health. Our mission is to is to improve health and healt...

jobs.lshtm.ac.uk

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Lara Goscé @laragosce.bsky.social · Apr 10

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 and the climate crisis in Latin America: a predicament of poverty, migration and displacement

Tuberculosis (TB) has long been associated with poverty and displacement, through food insecurity, overcrowding, poor living conditions and reduced access to healthcare, which significantly increase t...

gh.bmj.com

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Katherine Horton @kchorton.bsky.social · Apr 27

#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...

The potential impact of reductions in international donor funding on tuberculosis in low- and middle-income countries

Background Tuberculosis services in many settings rely heavily on international donor funding. In 2025, the United States Agency for International Development (USAID) was dismantled, and other countri...

www.medrxiv.org

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Katherine Horton @kchorton.bsky.social · Apr 9

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

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Peter MacPherson @petermacp.bsky.social · Apr 2

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...

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Rein Houben @reinhouben.bsky.social · Apr 4

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!

Peter MacPherson @petermacp.bsky.social · Apr 4

Distribution and transmission of
#tuberculosis in a high-HIV prevalence city
in Malawi: A genomic and spatial analysis 🛟🧪

journals.plos.org/globalpublic...

@uofgshw.bsky.social @jasonandrews.bsky.social @rachaelburke.bsky.social @jsalomon.bsky.social

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Finn McQuaid @cfmcquaid.bsky.social · Mar 26

In 2024, 68 million people were internally displaced by humanitarian crises, & are at increased risk of TB, the world's biggest infectious disease killer. We urgently need estimates to identify the scale of this problem & drive our response. We provide initial numbers here gh.bmj.com/content/10/3...

Thinking fast and slow: the urgency of crisis response must not lead us to overlook chronic needs such as tuberculosis

The number of people facing displacement due to humanitarian crises worldwide is increasing rapidly and is likely to continue. An average 10% year-on-year increase in the last 5 years resulted in 68.3...

gh.bmj.com

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Rein Houben @reinhouben.bsky.social · Mar 20

Very exciting to see this out. In many countries and for millions of people with TB, undernutrition is important and tragically 'unmanaged'. There are easy and cheap wins to be had, beautifully laid out by @tbtakenseriously.bsky.social and others. Start measuring, then we can start managing.

Finn McQuaid @cfmcquaid.bsky.social · Mar 20

Undernutrition is the leading risk factor for TB globally, so its very exciting to see this roadmap for integrating nutrition into the care of people with TB out now in @lancetgh.bsky.social, led by the amazing @tbtakenseriously.bsky.social
www.sciencedirect.com/science/arti...

A roadmap for integrating nutritional assessment, counselling, and support into the care of people with tuberculosis

Undernutrition—the leading risk factor for tuberculosis worldwide—is associated with impaired immunity, more extensive disease, delayed sputum convers…

www.sciencedirect.com

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Reposted by Rein Houben

TB Centre LSHTM @tb-lshtm.bsky.social · Mar 17

Happening a week today! If attending in person, please register ASAP - tickets are going fast!

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Tom Yates @tomayates.bsky.social · Mar 15

NEW COMMENT!

TB trials with purely microbiological primary endpoints give greater weight to outcomes that matter most, generalise better to non trial settings, are less biased if regimens differ in duration, and are often better powered

#IDSky @catherineberry.bsky.social @sgschumacher.bsky.social

Daniel Grint @danieljgrint.bsky.social · Mar 15

It was a pleasure working with @tomayates.bsky.social on this comment in @lancetmicrobe.bsky.social
It's time for new TB treatment trials to use a more focused primary outcome definition, moving on from the composite outcome that has prevailed for the last decade

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

Primary efficacy endpoints in phase 3 non-inferiority trials to establish new tuberculosis treatment regimens should only include microbiological outcomes

Treatment regimens for tuberculosis remain protracted and burdensome, both for patients to adhere to and for health-care providers to administer. Particularly, many current regimens for drug-resistant...

www.thelancet.com

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