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Peter MacPherson @petermacp.bsky.social · 4d

New preprint (NOT PEER-REVIEWED)

Community screening for #TB can reduce incidence. But we don’t know how best to target.

Targeting based on neighbourhood ARTI from convenience samples can substantially improve health and cost-effectiveness vs untargeted screening.

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

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Peter MacPherson @petermacp.bsky.social · 9d

⚡️New publication⚡️

We investigated the risk and determinants of mortality in people notified with Invasive Group A Streptococcal disease in Scotland between Jan 2017 and Dec 2024.

doi.org/10.1016/j.ij...

@uofgshw.bsky.social

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Peter MacPherson @petermacp.bsky.social · 12d

⚡️New publication⚡️

WHO clinical staging is not sufficiently accurate to identify advanced #HIV.

CD4 testing remains essential to reduce morbidity and mortality.

doi.org/10.1111/hiv....

@uofgshw.bsky.social
@joejarvis.bsky.social

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Reposted by Peter MacPherson

Katherine Horton @kchorton.bsky.social · 16d

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 ⬇️

Peter MacPherson @petermacp.bsky.social · 16d

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In a 🚨new🚨 preprint (NOT PEER REVIEWED) we modelled urban-rural TB trends from 2000-2023 in 26 countries with 4.6 billion people.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

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

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Peter MacPherson @petermacp.bsky.social · 16d

A great team project with @kchorton.bsky.social (on Bluesky) and colleagues not on Bluesky from @uofgshw.bsky.social, @tb-lshtm.bsky.social and @hsph.harvard.edu

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Peter MacPherson @petermacp.bsky.social · 16d

We found that #TB epidemics are rapidly urbanising, with profound implications for care and prevention programmes.

There are big differences between countries and global regions in the timing of urbanisation of TB epidemics, likely driven by demographic changes.

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Peter MacPherson @petermacp.bsky.social · 16d

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...

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Peter MacPherson @petermacp.bsky.social · 22d

Men are more than twice as likely as women to have prevalent #TB.

We did updated meta-analysis including over 4million people in 99 surveys.

Despite increasing focus on gender equitable TB responses, this gap has widened since we last assessed these data over a decade ago.

Katherine Horton @kchorton.bsky.social · 22d

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

Differences in Tuberculosis Prevalence by Sex Over 1993-2024: A Systematic Review and Meta-Analysis

Background: Tuberculosis (TB) prevalence is higher among men than women in low- and middle-income countries (LMICs). However, summary measures of sex difference

bit.ly

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Reposted by Peter MacPherson

Katherine Horton @kchorton.bsky.social · 22d

6/ @petermacp.bsky.social and I seem to be the only coauthors on Bluesky, but this work comes from a great team across @hsph.harvard.edu @uofglasgow.bsky.social @tb-lshtm.bsky.social @lshtm-tbmod.bsky.social

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Reposted by Peter MacPherson

Katherine Horton @kchorton.bsky.social · 22d

5/ These findings show that, despite calls for gender responsive TB prevention and care, disparities have increased over the past three decades. Effective strategies to reduce men’s risk of TB and to engage men in TB prevention and care remain essential to end TB.

NOT PEER REVIEWED

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Reposted by Peter MacPherson

Katherine Horton @kchorton.bsky.social · 22d

4/ The stability of pooled estimates doesn't mean sex ratios have remained consistent. We found evidence that male-to-female ratios likely increased 1.6% (95% CrI -1.0-6.2%) annually over the period 1994–2021, with the greatest increase in the Western Pacific region.

NOT PEER REVIEWED

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Reposted by Peter MacPherson

Katherine Horton @kchorton.bsky.social · 22d

3/ We fitted multi-level Bayesian regression models to estimate a pooled male-to-female prevalence ratio of 2.21 (95% CrI 1.94-2.50) for bacteriologically-confirmed TB.

That's the same point estimate as our previous review, but the two studies used different analytical methods.

NOT PEER REVIEWED

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Reposted by Peter MacPherson

Katherine Horton @kchorton.bsky.social · 22d

2/ We updated our systematic review and identified 99 TB prevalence surveys reporting sex-disaggregated results (with >4 million participants) conducted between 1993 and 2024 in 33 low- or middle-income countries.

NOT PEER REVIEWED

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Reposted by Peter MacPherson

Katherine Horton @kchorton.bsky.social · 22d

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

Differences in Tuberculosis Prevalence by Sex Over 1993-2024: A Systematic Review and Meta-Analysis

Background: Tuberculosis (TB) prevalence is higher among men than women in low- and middle-income countries (LMICs). However, summary measures of sex difference

bit.ly

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Reposted by Peter MacPherson

School of Health and Wellbeing, University of Glasgow @uofgshw.bsky.social · 29d

🆕paper co-authored by @petermacp.bsky.social

Key finding - Open tibia fractures result in significant costs to patients, the healthcare system and society in Malawi.

Re-balancing of health budgets is needed to prioritise trauma care.

doi.org/10.1371/jour...

Economic burden and cost-effectiveness of treatments for open tibia fractures in Malawi: Economic analysis of a multicentre prospective cohort study

Background Open tibia fractures result in substantial lifelong disability for patients, and are expensive to treat. As the injury typically affects young working men, the societal costs from open tibi...

doi.org

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Reposted by Peter MacPherson

Alison Farrell @alisonfarrell.bsky.social · Sep 4

As well as the modelling study by Molaro and colleagues that looks specifically at the effects of #health #aid reductions in #Malawi
journals.plos.org/plosmedicine...
@plos.org

The potential impact of declining development assistance for health on population health in Malawi: A modelling study

Author summary Why was this study done? Development assistance for health (DAH) is an important source of funding for public healthcare services in Malawi. Its contribution is expected to decline...

journals.plos.org

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Reposted by Peter MacPherson

Alison Farrell @alisonfarrell.bsky.social · Sep 4

Check out this new Perspective by #PLOSMedicine academic editor @petermacp.bsky.social and colleagues on the devastating effects on progress of health funding cuts in Africa:
journals.plos.org/plosmedicine...
@plos.org

Reductions in development assistance for health funding threaten decades of progress in Africa

Countries across Africa face health crises driven by aid cuts, shifting demography, and infectious and environmental threats. Renewed public health strategies, smarter investment, and stronger surveil...

journals.plos.org

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Peter MacPherson @petermacp.bsky.social · Aug 22

Reductions in development assistance for health funding threaten decades of progress in Africa

🦠🧪🛟

journals.plos.org/plosmedicine...

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Peter MacPherson @petermacp.bsky.social · Aug 15

osf.io/preprints/os...

OSF

osf.io

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Peter MacPherson @petermacp.bsky.social · Aug 15

About half of people with #TB are asymptomatic (aTB). Calls have been made to stratify treatment and estimate incidence based on aTB case definitions

In this preprint we raise concerns that symptoms are an inadequate & inconsistent classifier of TB state, being highly influenced by context

⬇️link

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Peter MacPherson @petermacp.bsky.social · Aug 6

I recently read this book, and couldn’t sleep for weeks - absolutely terrifying. Glad this is being highlighted as a key threat to planetary health.

en.m.wikipedia.org/wiki/Nuclear...

Nuclear War: A Scenario - Wikipedia

en.m.wikipedia.org

Reposted by Peter MacPherson

Peter MacPherson @petermacp.bsky.social · May 1

⚡️New preprint (not peer-reviewed)⚡️

In the SaDAPT trial with people with #HIV and #tuberculosis symptoms in 🇲🇼🇱🇸, we investigated if antiretroviral therapy should be initiated immediately, or delayed until TB results available. ssrn.com/abstract=523...

Outcomes (incl. IRIS) similar across both arms.

The front page of the preprint article, showing title and authors

Forest plot showing primary and secondary trial outcomes, with non-inferiority margins

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Reposted by Peter MacPherson

KNCV TB Plus | KNCV Tuberculosis Foundation @kncvtbplus.bsky.social · Jul 18

We are excited to share that the new @who.int Consolidated Guidelines - National TB Prevalence Surveys is out now!🎉

👏Our KNCV colleagues, Petra de Haas and Edine Tiemersma, contributed to the development of this valuable resource for #TB care and prevention.

www.who.int/publications...

#TBSky

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Reposted by Peter MacPherson

Tom Boyles @tomboylesid.bsky.social · Jul 18

Just saw the presentation at IAS. This is exactly the trial we needed. Previous attempts like SLATE missed the mark but you have done it, congratulations.

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Peter MacPherson @petermacp.bsky.social · Jul 18

Thanks Tom!

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