19 October-30 November 2020
The 51st Union World Conference On Lung Health
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Channel 1
Opening Ceremony
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Opening Ceremony
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Opening Ceremony: Marking The Union's Centennial Year
20 October 2020              2PM-3PM CEST
 
On 20 October 1920, representatives from 31 countries, recognising that a global health crisis – tuberculosis – could not be defeated without international collaboration and knowledge sharing, came together and founded The Union. One hundred years later, as the world struggles to confront a new infectious respiratory disease – COVID-19 – our founders’ vision remains as relevant as ever.

As The Union turns a century old, we also embark upon the first ever virtual Union World Conference. The opening ceremony will reflect on the journey so far and the distance left to travel.
 
We will hear from:
 - Her Imperial Highness Crown Princess Akishino of Japan
- President Bill Clinton
- World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus
- Yvonne Chaka Chaka, singer, entrepreneur, Global Health Advocate and humanitarian
- Divya Sojan, TB survivor and nurse
- Shannon Hader, Deputy Executive Director United Nations Programme on HIV/AIDS (UNAIDS)
- Katherine Maher, Chief Executive of the Wikimedia Foundation (Interviewed by Noam Cohen, WIRED)
- Claire Forlani, UK Film and TV Actress, and The Union’s TB Ambassador
- Dr Tamaryn Green, TB Survivor, Medical Doctor, Miss South Africa 2018
 
President of The Union, Professor Guy Marks, The Union’s Executive Director, José Luis Castro, and Dr Keren Middelkoop, Chair Coordinating Committee of Scientific Activities will also speak.

Please join our opening ceremony and we wish you an inspiring virtual Union World Conference.

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Channel 3
MTE-01-Meet the expert session: civil society
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MTE-01-Meet the expert session: civil society
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Health advocacy for access to care

Alternative respond to Covid-19 by the Civil Society Organisations in South Africa

Please note that the number of participants is limited to 50 for this session.

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Channel 4
MTE-02-Meet the expert session: Adult and Child Lung Health
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MTE-02-Meet the expert session: Adult and Child Lung Health
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TB vaccine for children

Please note that the number of participants is limited for this session.

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E-posters
EP05-Person-centred care: the advantages and challenges
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EP05-Person-centred care: the advantages and challenges
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

EP05-140-21-Using patient pathway analysis in Rwanda: methods, problems and the importance of data and sensitivity analysisThis patient pathway analysis was done to inform the alignment between the availability of tuberculosis diagnostic and treatment services at facilities in Rwanda and care seeking behaviour towards these facilities.
Puck Pelzer

EP05-141-21-Improving surveillance data quality in Nikshay: introduction of machine assisted deduplicationAll healthcare providers in India, including laboratories and chemists, are required to notify cases of tuberculosis (TB) in Nikshay - the national TB surveillance system - increasing the risk of duplicate notifications. To prevent this, a machine-assisted deduplication mechanism has been developed, providing an approximate 25% positive predictive value.
Jyoti Jaju

EP05-142-21-The paradox of free TB care in private-for-profit private care facilitiesThe provision of a public health intervention within private-for-profit facilities is morally appealing but can be faced with the challenge of overhead costs. In the implementation of PPM-DOTs models, businesses' operational costs must be considered and incentive packages tailored to mitigate these costs as part of tuberculosis care service for sustainability.
Dziedzorm Awalime

EP05-143-21-Pillar Two of the End TB Strategy: impact of bold policies and supportive systems on programme implementation in IndiaArticle documents the improvement in coverage of nutritional support scheme as a result of intensive monitoring of the same, reiterating the need for adequate political commitment with adequate resources for a tuberculosis free world
Deepak Balasubramanian

EP05-144-21-Comparison and analysis of different mode of administration for TB treatment in Papua New GuineaThis study compares treatment outcomes in tuberculosis (TB) patients using three modes of administration (MOA), including directly observed treatment (DOT) by treatment supporters, self-administrated treatment (SAT), and family model (FM). We also assessed adherence in a small cohort of multidrug-resistant TB patients with SAT versus FM.
Rakhat Akmatova

EP05-145-21-Patient-centred TB treatment support tools: a mixed method, randomised controlled pilot study exploring initial efficacy and refinement needsWe present the initial assessment of the tuberculosis (TB) treatment support tools (TB-TSTs) intervention. TB-TSTs links a patient-centred mobile application, a paper-based drug metabolite urine test and interactive communication with a treatment supporter. The study was conducted within a public respiratory specialised reference hospital in Argentina.
Sarah Iribarren

EP05-146-21-Evaluation of the accuracy of 99DOTS digital adherence technology for TB in Metro Manila, PhilippinesThe accuracy of 99DOTS, a mobile phone digital adherence tool enabling remote monitoring of tuberculosis (TB) drug intake, was evaluated in a Metro Manila pilot. Results from 103 participants showed the following findings: PPV=97.9%, NPV=0.0% and sensitivity=94.1%. 99DOTS adherence is corroborated by the IsoScreen used to represent true adherence status.
Jason Alacapa

EP05-147-21-Fully oral rifampicin-resistant TB treatment regimens: progress in removing injectable agents from high TB burden country policiesWhile progress has been made in high tuberculosis (TB) burden countries towards policy guidance for shorter and longer all-oral rifampicin- resistant tuberculosis (RR-TB) regimens recommended by the World Health Organization, results from the #StepUpforTB 2020 study shows slow changes in phasing out injectable agent use for routine RR-TB treatment.  
Pilar Ustero

EP05-148-21-Patient-centred care for drug-resistant TB: responding to diverse clinical and social circumstancesSouth African healthcare remains poorly responsive to the socio-economic and psychological needs of patients. Patients experience complex medical and social challenges, which belie a one-size-fits-all model of care. Service delivery needs to be differentiated in order to better address specific needs and vulnerabilities of individual patients.
Leila Mitrani

EP05-149-21-Perspectives on access to TB health services in Shigatse, Tibet, ChinaA qualitative study exploring the experiences and perspectives of access to tuberculosis (TB) care among people living with TB in Shigatse, Tibet China. Ten semi-structured interviews were conducted with Tibetan interpretation as well as analysis using an access-to-care framework to conceptualise determinants of access to TB care.
Victoria Haldane

EP05-150-21-Beyond free medical care: why TB patients seeking treatment in national TB programme facilities still face catastrophic expenses in the Philippines?This study determines the drivers of costs faced by tuberculosis (TB) patients seeking treatment in government facilities. Using a cross-sectional survey of 1,880 TB patients, it provides an estimate of the proportion of TB-affected families facing catastrophic cost in the Philippines.
Rosa Mia Arao

EP05-151-21-Short- and long-term outcomes of video observed TB treatment among patients in Chisinau, the Republic of MoldovaVideo Observed Treatment (VOT) in addition to Directly Observed Treatment Strategy (DOT) was piloted in the Republic of Moldova. A study involved 83 tuberculosis patients on VOT and 86 on DOT. VOT reduced required time and travel costs for treatment while maintaining high levels of adherence and favourable treatment results.
Svetlana Doltu

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E-posters
EP04-Learning from epidemiological analyses
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EP04-Learning from epidemiological analyses
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

EP04-128-21-Results of pulmonary TB screening for the elderly aged ≥ 65 years in Korea, 2019The KCDC selected six regions with a high tuberculosis (TB) incidence rate in the elderly, aged 65 years or over, and conducted TB screening. The project aims to early detect and treat elderly TB patients and prevent TB transmission among the elderly population. This paper describes the study results.
Heeae Kim

EP04-129-21-Excess mortality in TB patients diagnosed at hospital vs at primary healthcare in South AfricaInitial loss to follow-up among tuberculosis (TB) patients is a significant gap in the TB cascade and includes pre-treatment mortality. We evaluated all TB patients diagnosed at primary healthcare, district or tertiary hospitals in two sub-districts of Cape Town. We identified predictors of mortality and demonstrated the time to death using survival analyses.
Muhammad Osman

EP04-130-21-A geo-epidemiological approach to diagnose social inequities among territories vulnerable to TB in the North-East of BrazilIdentify the social inequalities associated with the occurrence of tuberculosis in areas at risk of the disease. This is an ecological study. For the analyses, the statistical model called Generalised Additive Models for Location, Scale and Shape, was used.
Ricardo Arcêncio

EP04-131-21-Poor linkage to care and high mortality among pregnant women with TB in South AfricaThis study describes linkage to care and mortality among pregnant women diagnosed with tuberculosis (TB) in Cape Town, South Africa. Using routinely collected TB data, we describe this cohort of pregnant women with TB, stratified by location of diagnosis and hospital vs. primary health care facility. 
Sue-Ann Meehan

EP04-132-21-Individual associated factors for developing tuberculous meningitis: a cross-sectional studyDiagnosis of tuberculous meningitis (TBM) is challenging. We analysed the data of demographics, comorbidities and concurrent tuberculosis (TB) for TBM and non-TBM in patients from January 2008 to December 2019 in Beijing Chest Hospital (Beijing, China). Individual associated factors for developing TBM were identified by using univariate and multivariate logistic regression.
Mailing Huang

EP04-133-21-Prevalence and risk factors of active TB in Chinese rheumatic patients: a multicentre, cross-sectional studyA tertiary, hospital-based and multicentre cross-sectional study was conducted between September 2014 and September 2015. Eligible patients with confirmed diagnosis of various rheumatic diseases were consecutively recruited and screened for active TB. Calculation of prevalence and analysis of risk factors along with data about demographic features, underlying diseases and past and current medications were obtained.
Xiaoqing Liu

EP04-134-21-Geospatial determinants of TB active case finding among men and working age adults in Lima, PeruIn screening programmes for tuberculosis (TB), men and working age adults often have lower participation. In an active case finding programme for TB in Lima, Peru, we aimed to identify locations that had higher than average attendance by men and working age adults.
Helen Jenkins

EP04-135-21-Geospatial mapping of TB burden in Anambra State, South-East NigeriaWe conducted a geospatial mapping of all the notified tuberculosis (TB) cases in the state to enable a visualisation of hotspots of TB transmission to be targeted with case finding interventions. Patterns of TB burden across the state showed marked differences in urban areas between local government areas in the state. 
Chukwuebuka Ugwu

EP04-136-21-Factors associated with health seeking behaviour of people to be evaluated for TB aged 15 years and above in Indonesia: tuberculosis prevalence surveyThis paper aims to examine the health seeking behaviour of people to be evaluated for tuberculosis (TB). This study included adults to be evaluated for TB aged 15 years old and above based on the Indonesia TB prevalence survey, within the initial behaviour model. 
Permata Silitonga

EP04-137-21-Seasonality and trend of TB incidence rate after GeneXpert MTB/RIF era: a study in a vulnerable region from Brazilian Eastern AmazonEcological study in Macapá, capital of the state of Amapá, region of the Brazilian Eastern Amazon. We applied the interrupted time series method for diagnosing seasonality and the Prais-Winsten method to classify the event trend.
Ricardo Arcêncio

EP04-138-21-TB incidence rates and their determinants: an ecological multicountry analysis, 2005-2015The study identified three intermediary social determinants of health that were associated with changes in tuberculosis (TB) incidence rates across 115 countries between 2005 and 2015. Further action to address these determinants may help to achieve global goals in TB incidence reduction by 2035.
Fiona Alma Koeltringer

EP04-139-21-Risk factors for mortality among patients with multidrug-resistant TB in Uganda: a case-control studyRisk factors for mortality among patients with multidrug-resistant tuberculosis (MDR-TB) in Uganda: a case-control study for patients in the 2016 cohort using the long MDR-TB treatment regimen. This was done under programmatic conditions. 
Enock Kizito

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E-posters
EP02-Challenges for randomised controlled trials on TB treatment
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EP02-Challenges for randomised controlled trials on TB treatment
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

EP02-110-21-International multicentre controlled trial to evaluate 1200mg and 1800mg rifampicin daily in the reduction of treatment duration for pulmonary TB from six to four monthsThe current treatment for drug-sensitive pulmonary tuberculosis (TB) involves taking drugs daily for six months. RIFASHORT is an international multicentre controlled clinical trial which evaluates higher doses of rifampicin with the objective of reducing the treatment duration for drug-sensitive pulmonary TB from six months to four months.
Tulika Munshi

EP02-111-21-Documenting challenges faced and lessons learned from implementation of STREAM – the world’s largest recruited multidrug-resistant TB clinical trialMulticountry clinical trial implementation is complex – from different regulatory requirements and approval processes to variable research infrastructure and capacity across settings. Here, we document challenges faced and lessons learned from STREAM – the first large-scale, multicountry clinical trial for multidrug-resistant tuberculosis.
Meera Gurumurthy

EP02-112-21-A method for baseline adjudication of TB diagnosis in children in a therapeutic clinical trial: experience from SHINEDiagnosing non-severe pulmonary tuberculosis (TB) in children is challenging.  Results in children adjudicated as having TB (in the SHINE trial comparing four vs six months of standard therapy) will be essential. The approach to adjudicate TB or not TB can help overcome challenges in paediatric TB studies in the absence of gold standard diagnostic tests.
Genevieve H Wills

EP02-113-21-Sustainability of the ACT4 randomised trial to improve initiation of TB preventive treatmentThe ACT4 randomised trial found that a health systems' intervention in strengthening management of latent tuberculosis (TB) infection was effective at increasing TB preventive therapy initiation rates in households contacts. In this follow up study, the sustainability of the ACT4 intervention was evaluated over the nine months following the end of the trial.
Olivia Oxlade

EP02-114-21-Utility of colour vision testing in screening for ethambutol-associated ocular toxicity in children treated for TB in the SHINE trialEthambutol-associated ocular toxicity (EAOT) is reported in 0.05-0.7% of children treated for tuberculosis (TB). Using a child-friendly colour vision test as a screening tool, there was no evidence of clinically significant EAOT in children taking ethambutol.  Colour vision testing in children is feasible but may not be necessary for standard drug-sensitive TB treatment.
Eric Wobudeya

EP02-115-21-Adolescents in a TB clinical treatment trial: characteristics of an under represented populationAdolescents represent approximately 10% of the global tuberculosis (TB) burden yet they are historically under represented in clinical trials, potentially limiting their access to new treatments. We examined enrolment patterns for adolescents in a TB Trials Consortium and AIDS Clinical Trials Group Phase III and rifapentine-containing treatment shortening trial for pulmonary TB (NCT02410772).
Kimberley Hedges

EP02-116-21-Investigator reported barriers and facilitators to adolescent recruitment, enrolment and retention in TB Trials Consortium Study 31/ACTG A5349In a randomised, phase III treatment shortening trial for drug-susceptible pulmonary tuberculosis, we evaluated barriers and facilitators of adolescent participation in clinical trials. Using the capability, opportunity, motivation and behaviour model, we constructed interview guides, conducted interviews with principal investigators across two research consortia and analysed interview transcripts.
Joan Mangan

EP02-117-21-Exploring antagonism in anti-TB drugs using a hollow-fiber modelIsoniazid is part of the frontline anti-tuberculosis (TB) regimen. We have shown that its inclusion in a rifampicin/isoniazid dual therapy model increases the incidence of drug-tolerant, lipid-rich cells that stain as if respiring but with a compromised cell wall. This data is indicative of clearance antagonism occurring in TB chemotherapy.
Robert Hammond

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E-posters
EP10-Overcoming barriers in the contact cascade of care
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EP10-Overcoming barriers in the contact cascade of care
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

EP10-187-21-A missed opportunity: active contact investigation of diagnosed TB patients in NigeriaPeople who have been in close contact with bacteriologically confirmed pulmonary tuberculosis (TB) patients constitute a high-risk group for developing TB disease. Active household contact investigation of index TB patients demonstrates a great opportunity to increase a diverse pool of human resources, capacity to diagnosis and to notify additional TB cases.
Sani Useni

EP10-188-21-Risk of developing active multidrug-resistant TB among contacts in Taiwan, 2016-2018Identifying at-risk contacts, who have been exposed to a multidrug-resistant tuberculosis (MDR-TB) index patient, to see if they develop active disease would help advancing prevention of MDR-TB in Taiwan. In addition, active follow-up and prioritising those household or IGRA-positive contacts for latent TB treatment may further decline the incidence of MDR-TB. 
Pin Hui Lee

EP10-189-21-Utility of interferon gamma/tumor necrosis factor alpha FluoroSpot assay in differentiation between active TB and latent TB infection: a pilot studyWe aimed to provide a highly sensitive and practical auxiliary method for tuberculosis (TB) differential diagnosis. In this abstract, we demonstrated the diagnostic accuracy of the interferon gamma/tumor necrosis factor alpha (IFN-γ/TNF-α ) FluoroSpot assay for differentiating active TB from latent TB infection. 
Ziyue Zhou

EP10-190-21-Results of management latent TB infection in Quang Nam province, Viet Nam, 2017-2018Results of the management of latent tuberculosis (TB) infection during the period of 2017-2018 in Quang Nam province, Viet Nam. Interventions have shown to be effective in increasing the ability to identify, screen TB and treat latent TB infection among household contacts of TB patients.
LV Vinh

EP10-192-21-Effectiveness of contact tracing intervention for improving TB case detection in NigeriaSystematic investigation of contacts of index TB cases for active disease has remained a priority active case finding strategy. Stakeholders for tuberculosis (TB) control need to apply the right strategy, job aid, tools and training for health workers to help standardise TB information and empower communities with the right TB knowledge
Chidubem Ogbudebe

EP10-193-21-Dilemma in contact investigation: to expand or notContact investigation as a part of Dutch tuberculosis (TB) policy aims for early case detection, treatment and prevention of TB transmission. Risk assessment forms a basic approach to the organisation of contact investigation.
Sophie Toumanian

EP10-194-21-Piloting a shortened regimen for the treatment of latent TB infection in two provinces of Viet NamIn 2019, Friends for International TB Relief, together with the Viet Nam National TB Programme, implemented community-based tuberculosis (TB) case finding campaigns with integrated latent TB infection testing and treatment using a shortened regimen in two provinces of Viet Nam. We herein describe the results of these activities.
Thuy Thu Thi Dong

EP10-195-21-Prevalence of latent TB infection and predictive factors among working-age population in urban and rural area of Northern Guangdong, China: a cross-sectional studyChina has one of the highest burdens of latent tuberculosis (TB) infection (LTBI). Studies, which mainly focused on high-risk population, observed LTBI prevalence ranging from 9% up to 70%. The goal of this study was to describe LTBI burden in the general population, especially in those of working age, and determine its associated factors.
Fangjing ZHOU

EP10-196-21-Impact of civil society advocacy on the introduction of TB LAM testing in PEPFAR-eligible countriesUptake of tuberculosis (TB) LAM testing in high TB and HIV burden countries has been limited despite a demonstrated mortality benefit among people with advanced HIV. We reviewed FY2018 and FY2019 PEPFAR country operational plans to evaluate the impact of advocacy on TB LAM uptake in PEPFAR-eligible countries.
David Branigan

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EP08-COVID-19 and TB: friends or foes?
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EP08-COVID-19 and TB: friends or foes?
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

EP08-168-21-TB and Covid-19: Bangladesh perspective and challengesCovid-19 posed challenges in tuberculosis (TB) control in Bangladesh. During the first two months of the pandemic, a decrease in TB patients was reported. Patient-centred care was ensured by providing medicine to the patients and using telecommunication. Interim and long-term preparedness is required to resume enhanced momentum of TB control.
Mahfuza Rifat

EP08-169-21-The impact of Covid-19 on TB control in the Coast General Teaching and Referral Hospital, Mombasa County, KenyaKenya confirmed its first case of Covid-19 on 12 March 2020. In an effort to combat the pandemic Kenya, like the rest of the world, introduced some changes to its health service delivery. Being a country with a high tuberculosis (TB) burden, this had an impact on TB patients accessing care.
Cosmas Mwashumbe

EP08-170-21-Design and organisation of a temporary intensive care ward in response to the COVID-19 pandemicCOVID-19 placed a heavy burden on medical services. We designed and organised a temporary intensive care unit (ICU) ward within 48 hours. The space design, environmental cleaning and patients' daily care were the key steps to organising a practical ICU ward during the COVID-19 pandemic.
Xiangfeng Li

EP08-171-21-Trend analysis of exponential increase of COVID-19 cases in PakistanThe study was conducted to see the trends of COVID-19 among the Pakistani population. Pakistan started to feel the impact of the outbreak in mid-March with an increase in the number of cases at an alarming pace. So far, Sindh and Punjab province are the worst hit provinces with wide-spread community transmission.
Nadia Noreen

EP08-172-21-Sustaining TB services during the COVID-19 pandemic: experience and lessons learned from Nigeria in 2020Measures put in place to control the COVID-19 pandemic had the potential for interrupting tuberculosis (TB) services and erasing the gain made in TB control. Sustaining TB programmes during the COVID-19 pandemic became a priority of the national TB programme in Nigeria and the steps taken are documented and described in this study. 
Fadare Amos Omoniyi

EP08-175-21-Psychological experiences of mobile van TB screening team during COVID- 19 pandemic in Blantyre, MalawiResults have shown that health workers, working under MDU, experience several psychological challenges in this era of the COVID-19 pandemic and have compromised TB screening services. Therefore, mental health interventions are needed to mitigate these challenges. Self-coping style and psychological growth are important for health workers to maintain mental health.
Khwima Esther Mkalira

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E-posters
EPTBS-TBScience 2020 - E-posters - Displayed All Conference Days
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EPTBS-TBScience 2020 - E-posters - Displayed All Conference Days
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All TBScience 2020 E-posters will be displayed from 10 am Central European Summer Time (CEST), on Wednesday, 21 October for the duration of the conference and beyond

EP-TBS-01-Increased neutrophil count and decreased neutrophil CD15 expression correlate with TB disease severity and treatment response
Lerato Ndlovu

EP-TBS-02-Genome-wide identification of Mycobacterium tuberculosis genetic markers associated with the history of BCG vaccination
Kamela Charmaine S. Ng

EP-TBS-03-Characterization of regulatory B-cells for tuberculosis management
Irene Latorre

EP-TBS-04-Different antimycobacterial activity of alveolar macrophages in various lung legions of tuberculosis patients
Sergey Skornyakov

EP-TBS-05-Plasma mediators of phagocytosis in tuberculosis patients during anti-TB treatment and zinc supplementation
Victory Edem

EP-TBS-06-Discerning divergent tuberculosis endotypes: A meta-analysis of individual patient data
Andrew DiNardo

EP-TBS-07-Plasma Interferon (IFN)-g Inducible Protein 10 (IP-10) levels but not the QuantiFERON Gold plus assay correlate with disease severity and paradoxical reactions in extrapulmonary tuberculosis
Isabelle Suarez

EP-TBS-08-Host immune factors related to non-multidrug resistant tuberculosis with treatment history in Vietnam
Naoto Keicho

EP-TBS-09-Risk factors for the development of tuberculosis in children with chronic non-specific lung diseases.
Sofya Nakonechnaya

EP-TBS-10-Polyfunctional T-cells and IL-2 production decrease during pregnancy in women with latent TB infection
Jyoti Mathad

EP-TBS-11-Neutrophils Contribute to Tuberculosis-linked Inflammation and lung pathology
Caleb Nwongbouwoh Muefong

EP-TBS-12-Association of neutrophil-derived inflammatory mediator levels with lung pathology in active tuberculosis at diagnosis
Caleb Nwongbouwoh Muefong

EP-TBS-13-Characterising the BCG-induced antibody response for antigen discovery
Rachel Tanner

EP-TBS-14-ESAT-6 / CFP-10-stimulated metabolic activity of pleural fluid cells if cured tuberculosis or TB / HIV
Sergey Skornyakov

EP-TBS-15-Blood-Based Biomarkers of Tuberculosis in Children Integrating Metabolomic and Transcriptomic Data
Jeffrey A Tornheim

EP-TBS-16-Identification of TGF-β1 in pleural tuberculosis: the possible role in fibrosis
Silvio Renan Pinheiro Victor de Araújo

EP-TBS-17-Analysis of serum microRNAs as pulmonary tuberculosis biomarkers
JaeIn Jung

EP-TBS-18-Up-regulated programmed death protein 1 expression on CD4 T cells in patients with MDR-TB  associated with lung lesion and mycobacterial load
Qi Tan

EP-TBS-19-Malnutrition affects levels of vascular endothelial growth factor levels among children and adolescents with pulmonary tuberculosis?
Caio Pluvier Duarte Costa

EP-TBS-20-Towards identification of protein markers of Mycobacterium tuberculosis H37Rv extracellular vesicles (EV)
MEHALENE JAYARAM

EP-TBS-21-Increased frequency of CD39+ regulatory T cells in the pleural fluid of patients with Tuberculosisin comparison to other exudative causes
Ana Paula Santos

EP-TBS-22-Longitudinal analysis of M. tuberculosis-specific T cell responses demonstrates dynamic T cell responses to ESAT-6 and CFP-10 during pregnancy independently of mitogen responses.
Aparajita Saha

EP-TBS-23-Serum Cytokine Profile as Biomarker for Multi-drug Resistant Tuberculosis
Alahaman Nana Boakye

EP-TBS-24-Reanalysis and validation of Tuberculosis genes signature in blood and pleural fluid from patients with exudative pleural effusion
Raquel da Silva Corrêa

EP-TBS-25-TimBre, Cough based screening of Pulmonary Tuberculosis using Machine Learning that is Explainable and Interpretable
Rahul Pathri

EP-TBS-26-HbA1C as prognostic factor in PTB
Sarang Patil

EP-TBS-27-Better intradermal delivery for bacille Calmette-Guérin (BCG) vaccine by microneedles in healthy adults of S. Korea
Hyejon Lee

EP-TBS-28-MULTIPLEX BIOMARKER ASSAY FOR DETECTION OF MYCOBACTERIUM TUBERCULOSIS
Puneet Gupta

EP-TBS-29-Role of the chemokine receptor CXCR3 in the recruitment and retention of lung resident memory T cells following a pulmonary TB vaccine. 
Warwick Britton

EP-TBS-31-Benefit of Quantiferon-TB Gold plus in incidence of TB disease in Heath care workers of Central Chest Institute of Thailand
piamlarp sangsayunh

EP-TBS-32-The blood monocyte/lymphocyte, neutrophil/lymphocyte and platelet/lymphocyte ratios in children with pulmonary tuberculosis
Larissa Gorbach

EP-TBS-33-Pulmonary tuberculosis patients have an anaerobe-enriched microbiota associated with a pro-inflammatory peripheral host immune phenotype
Charissa Naidoo

EP-TBS-34-The epidemiologic impact and cost-effectiveness of new tuberculosis vaccines on rifampicin resistant and multidrug resistant tuberculosis in India and China
Chathika Weerasuriya

EP-TBS-36-Novel, culture-free, same-day TB diagnosis with ultrasensitive ELISA
Rikiya Takeuchi

EP-TBS-37-Tuberculosis screening in point-of-care settings: Proof-of-concept for a fast and easy sample-to-answer qPCR-based protocol
Alexandre Dias Tavares Costa

EP-TBS-38-Diagnostic accuracy of three urine lipoarabinomannan tuberculosis assays in HIV-negative outpatients
Tobias Broger

EP-TBS-39-To Study The Presence Of Live Mycobacterium Tuberculosis In Resected Lung Specimens Of Patients Undergoing Lung resection Surgery For Post-Tuberculosis Sequelae
Pallavi Purwar

EP-TBS-40-What can tuberculosis prevalence surveys tell us about the duration of asymptomatic bacteriologically-positive disease?
Chu-Chang Ku

EP-TBS-41-An RNA signature for tuberculosis risk in pregnant women: a prospective cohort study from India
Jyoti Mathad

EP-TBS-42-Analysis of mycobacterial trans-renal DNA for the diagnosis of Tuberculous Meningitis in adults.
Manisha Dass

EP-TBS-43-Developing a tool to identify and screen Latent Tuberculosis Infection (LTBI) with likelihood of progression to active Tuberculosis (ATB)
Prashant Singh

EP-TBS-44-QuantiFERON TB plus-negative results in clinically diagnosed paediatric tuberculosis: immune suppression or misdiagnosis?
Gloria Ivy Mensah

EP-TBS-45-Evaluation of a blood-based antigen test for tuberculosis in HIV-exposed children younger than 5 years
Tony Hu

EP-TBS-46-Adverse drug reactions in MDR TB Patients on ATT
Sarang Patil

EP-TBS-47-Species and Drug Susceptibility profile of Non-tuberculous Mycobacteria isolated from presumptive TB cases
PRIYA RAJENDRAN

EP-TBS-48-MAMA-PCR assay for the detection of point mutations associated with drug resistance in Mycobacterium tuberculosis clinical isolates
Raquel Muñiz-Salazar

EP-TBS-49-Genomic diversity in Mycobacterium tuberculosis from human lung resections reveals a high degree of multiclonal infections in a high-burden MDR-TB setting
Miguel Moreno-Molina

EP-TBS-50-Pathogen genome sequencing to guide treatment regimen designs for multidrug-resistant tuberculosis
Hans-Peter Grobbel

EP-TBS-51-An evolutionary functional genomics approach identifies novel candidate regions involved in isoniazid resistance in Mycobacterium tuberculosis
Victoria Furió

EP-TBS-52-Antibiotic Resistance Profile Determination Using Whole Genome Sequencing
Ryan Howard

EP-TBS-53-Rapid genomic drug resistance prediction from clinical Mycobacterium tuberculosis specimens using amplicon based deep sequencing based on Deeplex-MycTB
Stefan Niemann

EP-TBS-54-Multi-resistant tuberculosis and HIV infection in Kinshasa: 2011-2018. DRC “Epidemiological, clinical and therapeutic aspects”
Nicole ANSHAMBI

EP-TBS-55-Long Read DNA Sequencing of XDR/MDR Tuberculosis Samples to Investigate Factors Leading to Resistance and Virulence
Michael Harris

EP-TBS-56-Genome-wide detection of epistasis in antibiotic resistant M. tuberculosis
Anna Green

EP-TBS-57-Population structure, biogeography and transmissibility of Mycobacterium tuberculosis
Luca Freschi

EP-TBS-58-Safety and Efficacy of an MDR-TB All-oral Short-course Regimen in China: An Preliminary Analysis of the MDR-Chi clinical trial
Liang Fu

EP-TBS-59-Drug exposure and minimum inhibitory concentration predict pulmonary tuberculosis treatment response
Xubin Zheng

EP-TBS-60-A novel therapeutic vaccine against multi-drug resistant tuberculosis by T cell-immunity in phase 1 clinical trial.
Masaji Okada

EP-TBS-61-Improving the safety of TB therapy with novel diagnostic biomarkers of liver toxicity – a study in UK and Ugandan patients
Derek Sloan

EP-TBS-62-Tuberculosis meningitis mouse model
Tuhina Gupta

EP-TBS-63-Pharmacokinetics of the three-drug fixed-dose dispersible tablet in children
Aziza Pakhlavonova

EP-TBS-64-Does BCG Vaccination protect against infection with Mycobacterium tuberculosis in Vietnamese schoolchildren?
Puck Pelzer

EP-TBS-65-Time to positivity as a surrogate biomarker of time to culture conversion
Belén P. Solans

EP-TBS-66-Use of the contact management register to identify those with Active and Latent TB, Kenya, Jan-March 2020
RHODA POLA

EP-TBS-67-Predicting Efficacy Outcome of Nine Tuberculosis Drugs in Phase 2a First-in-patients Studies
Nan Zhang

EP-TBS-69-Predicting optimal treatment durations for tuberculosis patients: a risk stratification algorithm and clinical simulation tool
Marjorie Imperial

EP-TBS-70-Adverse Drug Reactions in MDR TB Patients on Category IV Regimen in Western Odisha
SUMAN KUMAR JAGATY

EP-TBS-71-The effect of antiretroviral therapy and preventive tuberculosis therapy with anti-TB drugs on the duration of TB remission in HIV-infected patients
Igor Medvinskiy

EP-TBS-72-A Urine Colorimetric Assay for Levofloxacin Concentrations and Optimized Regimen Development
Prakruti Rao

EP-TBS-73-Development and Application of an Integrated Biomarker - Clinical Endpoint Tool for Late Stage TB Regimen Development and Clinical Trial Design
Marjorie Imperial

EP-TBS-74-Leveraging Neural Networks and Imaging Experts in Loops for Automated Tuberculosis Screening Using Chest Radiographs in Population Screening Programs to ensure efficient workflows.
Amit Kharat

EP-TBS-75-A model for the integration of traditional medicine into conventional medicine for the treatment of Tuberculosis (TB) in Zimbabwe
Winnet Enerita Chipato

EP-TBS-76-Point-of-Care Saliva Assay for Levofloxacin Concentrations and Personalized Dosing in Patients with Multidrug-Resistant Tuberculosis in Tanzania
Sagal Mohamed

EP-TBS-77-PBPK Model Informed Prediction to Evaluate the Effect of Renal Impairment and OCT genotypes on the Ethambutol Disposition
Yumi Park

EP-TBS-78-Development of Population Pharmacokinetic Model of the First-line anti-TB drugs in Korean patients with TB for Therapeutic Drug Monitoring Guided Dose Adjustment
Yumi Park

EP-TBS-79-Model Informed Personalized Dosing Algorithm Development for TB Therapy in Center for Personalized Precision Medicine (cPMTb)
Yumi Park

EP-TBS-80-Classifying adherence trajectories: an innovative tool for regimen development
Stephanie Law

EP-TBS-81-Predicting pretomanid penetration into patient lesions of tuberculosis
Jacqueline Ernest

EP-TBS-82-Rifapentine pharmacokinetics and pharmacodynamics: murine and human models to identify optimal dosing for treatment of latent M. tuberculosis infection
Jacqueline Ernest

EP-TBS-83-SLCO1B1 and SLC10A1 polymorphism and plasma rifampin concentrations in patients with co-morbidity tuberculosis-diabetes mellitus in Baja California, Mexico
Ricardo Perea-Jacobo

EP-TBS-84-Individual-Level Data Meta-Analysis of Adverse Events from Clinical Trials of Drug Sensitive Tuberculosis Treatment Regimens
Leah Jarlsberg

EP-TBS-85-G-clamp-inspired ligands and their effects on G-quadruplexes from Mycobacterium tuberculosis
Egor Shitikov

EP-TBS-86-Prediction of early bacterial activity (EBA) of bedaquiline in tuberculosis
Federico Romano

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E-posters
EP07-Improving TB care in children
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EP07-Improving TB care in children
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

EP07-159-21-Detecting and preventing paediatric TB through systematic household contact investigations in nine sub-Saharan countriesWe describe yields in tuberculosis (TB) detection and TB preventive therapy cascades - from screening to treatment completion - obtained during an intervention supporting systematic household contact investigation of paediatric TB index cases across nine sub-Saharan countries.
Jean-Francois Lemaire

EP07-160-21-Paediatric TB detection and treatment cascade in nine sub-Saharan countries following the CaP-TB interventionWe prospectively documented retention in the paediatric tuberculosis (TB) care cascade - from screening to treatment outcomes - during a comprehensive intervention, including paediatric specific systematic symptoms screening in health facilities, increased access to Xpert MTB/RIF testing, intensified household contact investigation and treatment of drug-sensitive TB with child-friendly formulations across nine sub-Saharan countries.
Shirin Kakayeva

EP07-161-21-Increasing paediatric TB detection and treatment in private health sector in IndiaWe share findings from the intervention on integrating comprehensive paediatric tuberculosis (TB) care cascade among private healthcare facilities in India. This includes evidence from intensified case finding activities in private facilities, enhancing their access to government’s free Xpert MTB/RIF diagnostics and WHO approved child-friendly fixed dose combination (FDC) dispersible drugs.
Karun Sandeep Veesa

EP07-162-21-Training physicians in India to interpret paediatric chest radiographs according to World Health Organization research methodologyChest radiography is the standard for diagnosing paediatric lower respiratory infections in low- and middle-income countries. Research in India required training local physicians to interpret chest radiographs following an updated World Health Organization interpretation method. We described the methodology for training Indian physicians and evaluated the training’s effectiveness.
Eric D McCollum

EP07-163-21-Care cascade of contact screening and preventive therapy among children under five in high-burden districts of NepalContact screening and provision of preventive therapy for under 5s as one intervention to prevent childhood TB in 38 high-burden districts of Nepal from 2017. Care cascade constructed in this paper focuses on contract tracing done during the period of March 2018-Dec 2019.
Suvesh Kumar Shrestha

EP07-164-21-Paediatric latent TB infection cascade of care from the TB and Leprosy Free Majuro community mass screening projectTB and Leprosy Free Majuro was a tuberculosis/latent tuberculosis infection (TB/LTBI) mass screening campaign implemented by the Republic of the Marshall Islands' Ministry of Health, on Majuro Atoll, from June to November 2018. It offered screening and treatment for LTBI in children 0-14 years old with varying success depending on age cohort.
Rachel Dwilow

EP07-165-21-Improvement of screening for childhood TB in Senegal coupled with screening for malnutrition: pilot study in the health districts of Thiès and Tivaouane, SénégalWe carried out operational research on the integration of the two tuberculosis (TB) and malnutrition control programmes to improve the screening of these diseases in children aged 0 to 14. This research developed by OMS/TDR shows that it can help the programme to improve the screening of childhood TB in Senegal.
Nafissatou Oumar Toure

EP07-166-21-Barriers to uptake of isoniazid preventive therapy among eligible child household contacts of TB patients in Southern NigeriaThis research explores the barriers to the uptake of isoniazid preventive therapy among eligible child contacts (under 6 years of age) of TB patients in six states of Southern Nigeria. Study findings highlight both patients and health systems factors.
Chukwuka Alphonsus

EP07-167-21-The state of paediatric, rifampicin-resistant TB in Khayelitsha, South AfricaOutcomes for paediatrics who receive rifampicin-resistant TB (RR-TB) treatment are excellent. Despite universal access to Xpert in South Africa, the frequency of paediatric cases detected has not increased, suggesting that diagnosis of RR-TB in paediatrics remains a challenge. Efforts to improve case detection, contact assessment and appropriate treatment initiation are urgently needed.
Johnny Daniels

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E-posters
EP03-Digital technology in the fight against TB
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EP03-Digital technology in the fight against TB
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

EP03-118-21-Implementation of artificial intelligence for presumptive TB screening in Nagpur, IndiaIntroduction of newer technologies such as artificial intelligence in detection of diseases including tuberculosis (TB) are being piloted for efficacy and effectiveness. One such tool - qXR - was implemented for chest x-ray screening followed by microbiological testing for confirmation of TB. Lessons learned from the pilot can be used for scale-up.
Shibu Vijayan

EP03-119-21-Decentralised drug-resistant TB treatment challenges in South Africa and options for implementation of a smartphone application based on latest guidelinesSouth Africa has the third highest number of notified cases of drug- resistant tuberculosis. We discuss use of behaviour change theory to understand key barriers to awareness of, and access to, new care and treatment guidelines, as well as the development of a novel point-of-care decision supporting smart phone application.
Susanne Luedtke

EP03-120-21-Disease patterns on computer-assisted chest radiography in a community-based prevalence survey for TBCommunity-wide active case finding (ACF) for tuberculosis (TB) is a proposed intervention to reduce the burden of the disease. Computer-assisted radiography is an essential tool in the ACF intervention and can potentially be used to screen for undiagnosed, non-communicable diseases. We described the observations from a prevalence survey in communities in Blantyre.
Hussein Twabi

EP03-121-21-Integrated digital adherence technologies for TB: determinants of technology-derived adherenceThe Integrated Digital Adherence Technology Initiative (IDAT) enroled 12,100 patients in various technologies - 99DOTS (directly observed treatment, short course), MERM (medication event reminder monitor system, and video observed therapy (VOT) - across eight districts and three states in India. Heterogeneity in the outcome measure of technology-derived adherence is observed with various systems, technology and temporal and patient-level factors, affecting DAT uptake and engagement. 
Sirisha Papineni

EP03-122-21-Implementing a referral system for drug-resistant TB patients to maximise treatment linkages to the public sector and minimise the treatment initiation time in Mumbai, IndiaAchieving early elimination requires a strong referral mechanism where patient and private hospitals engage throughout the treatment. PATH is collaborating with the Mumbai Corporation to link privately diagnosed drug-resistant tuberculosis patients to the public sector. Effective referral mechanism and implementation strategy has resulted in successful patient linkages to the public sector.
Dnyaneshwar Waman

EP03-123-21-Methods for estimating spatial and time-varying transmission patterns of TB in Espirito Santo, Brazil, between 2005-2013Tuberculosis (TB) case notification data is often collected for surveillance. We describe a method to estimate reproductive numbers with spatial variability using this data. We correlate estimated reproductive numbers in four municipalities in Espirito Santo, Brazil, with data from a concurrent household contact study and RFLP to understand transmission dynamics.

Benjamin Rader

EP03-124-21-eHealth in the future of TB medicines management: a case of a TB medicines web-based ordering and reporting system in UgandaIn developing countries, healthcare systems face major challenges with tuberculosis (TB) medicines management and reporting. Electronic TB medicines ordering and reporting systems facilitate information gathering for healthcare decision support by enhancing the speed and accuracy of data transmission and better stock monitoring, thus ensuring uninterrupted medicine availability.
Hawa Nakato

EP03-125-21-How can we find TB patients not linked to care? Lessons learned from a systematic tracing process implemented in the Western Cape Province, South AfricaTuberculosis (TB) case finding and treatment initiation is a major challenge in the Western Cape, South Africa. Linkage to care has individual benefits and reduces risk of onward transmission. Patient case finding requires use of different strategies, creativity and flexibility. 
Nosivuyile Vanqa

EP03-126-21-An assessment of the effectiveness of mobile community-based TB screening in Blantyre, Thyolo and Mwanza, in MalawiMobile van intervention has proved to be a viable strategy in finding missing active tuberculosis (TB) cases. All cases have been referred to the nearest hospitals for treatment and proper management. Sustainability of this intervention within the National TB Control Programme will see Malawi achieving its goal of ending TB infection in the country.
Allan Chimpeni

EP03-127-21-Decentralising access to digital information management to treatment supporters level for efficient real-time patient managementTreatment supporters (TS) counsel and follow up with TB patients until treatment completion. With Nikshay, India’s TB patient management system, treatment supporters can log in and update a TB patient’s health record. On treatment completion, the TS' honorarium can be processed digitally without delay.
Manu Easow Mathew

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E-posters
EP06-TB: data matters
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EP06-TB: data matters
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November. .

EP06-152-21-Assessment of TB underreporting by level of reporting system in Lagos, NigeriaAssessment of tuberculosis (TB) underreporting by level of reporting system, Nigeria. It was a quantitative, descriptive study using secondary data from an inventory study on TB reporting knowledge, attitude and behaviour conducted in 2017 in Lagos State to assess TB underreporting by type and level of health facilities, including associated factors.  
Mustapha Gidado

EP06-153-21-Improving TB treatment outcomes through effective linkage of transfer out patientsThe transfer out tool proved to be an effective strategy in referral and linkage for all tuberculosis (TB) patients who prefer continuum of care at facilities of their convenience. TB control programmes should consider adopting this tool and roll it out to all TB sites to improve quality of care. 
Stella Omulo

EP06-154-21-Nationwide surveillance of emerging isoniazid resistance after implementation of isoniazid preventive therapy for TB contactsAlthough population isoniazid resistance does not increase due to isoniazid preventive therapy, consider to provide isoniazid resistance as a priority of developing rapid drug susceptibility test for individuals who have developed TB after isoniazid preventive therapy can further advance propagation of prevention programme with trust.
Pei-Chun Chan

EP06-155-21-Review of the epidemiological mathematical modelling literature to inform TB vaccination development and strategiesMathematical models provide valuable information to aid the development of tuberculosis (TB) vaccines and vaccination strategies. Evaluating the impact of different vaccine characteristics in varied epidemiological settings such as exploring age, spatial hotspot and risk group targeting, as well as accounting for HIV, multidrug-resistance and population endemicity, can inform country-level implementation of novel TB vaccines.
Rebecca A. Clark

EP06-156-21-Strengthening hospital DOTS linkage using ad hoc staff to find missing TB cases: The Aminu Kano Teaching Hospital ExperienceAminu Kano Teaching Hospital (AKTH) is the largest tertiary facility in Kano state with an average daily hospital attendance of 862 patients. We sought to improve facility based active case finding by engaging trained ad hoc staff and deploying them across service delivery points over a period of time.
Mamman Bajehson

EP06-157-21-Incorporating patient reporting patterns to evaluate geographically targeted TB interventions in Dhaka, BangladeshTuberculosis (TB) is geographically heterogeneous and geographic targeting can improve the impact and efficiency of TB interventions. However, standard TB notification data may not sufficiently capture this heterogeneity. Better understanding of patient reporting behaviour may improve our ability to use notifications to appropriately target interventions.
Isabella Gomes

EP06-158-21-Lessons from a data quality assessment of TB notifications in Zambia: the case of under notification in a national TB programmeNational tuberculosis (TB) programmes should conduct periodic data quality assessments (DQAs) to validate notifications data. Findings will be very useful in designing future programming and implementation. The findings underscore the urgent need to strengthen the linkage to care. National TB programmes could potentially increase the TB treatment coverage by restoring data management systems.
Patrick Lungu

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E-posters
EP01-Resisting the resistance
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EP01-Resisting the resistance
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

EP01-100-21-Pharmacokinetics of anti-TB drugs in multidrug-resistant TB patients in IndiaA pharmacokinetic (PK) study of drugs used to treat multidrug-resistant (MDR) tuberculosis (TB) was undertaken in 350 adult MDR-TB patients treated according to the prevailing guidelines in India. Factors influencing drug PK and end of intensive phase status were also determined. Results of this study will be discussed.
Agibothu Kupparam Hemanth Kumar

EP01-101-21-Multidrug-resistant TB and its determinants of health service, community and social context in the state of São Paulo, BrazilThis study presents the social determinants of health in relation to the occurrence of multidrug-resistant tuberculosis, key information for disease control in regions with great social inequity. We emphasise the importance of socioeconomic, demographic and health system structure conditions for the spread of the disease.
Ricardo Arcêncio

EP01-102-21-Decentralised care for rifampicin-resistant TB in Western Cape, South Africa: a laboratory cohort studySouth Africa implemented a policy to decentralise rifampicin-resistant tuberculosis (RR-TB) care in 2011. We used laboratory data from the Western Cape province to assess patterns of RR-TB care and identify changes in hospitalisation rates, length of hospital stay and travel burden from 2012-2014. We compared Cape Town with more rural districts.
Helen Jenkins

EP01-103-21-Effectiveness, safety and feasibility of nine-month treatment regimen for rifampin-resistant TB in the PhilippinesThe short nine-month multidrug-resistant tuberculosis regimen had a high treatment success rate (74 percent) with a favourable safety profile in a prospective single-arm study conducted in the Philippines during 07/2015-12/2016. Nine-month treatment regimen operational research had a major impact on building national capacity and infrastructure for programmatic adoption of the new regimen in country.
Vivian Lofranco

EP01-104-21-Characterising multidrug-resistant tuberculosis transmission in rural KwaZulu-Natal: a prospective cohort studyThis study combined whole genome sequencing of 129 Mycobacterium tuberculosis (Mtb) isolates with demographic data from patients with multidrug-resistant TB in KwaZulu-Natal, South Africa. Transmission clusters based on genomic differences were identified. Relationships between demographic characteristics, Mtb lineage, rpoB mutation and transmission clustering were examined, aiming to elucidate drivers of Mtb transmission.
Cassandra Fairhead

EP01-105-21-Effectiveness and safety of use of bedaquiline and delamanid in combination for drug-resistant extrapulmonary TB in Mumbai, IndiaMédecins Sans Frontières has been providing treatment, including bedaquiline and/or delamanid, to patients with drug-resistant tuberculosis (TB) in Mumbai since 2015. Cases are referred with complex resistance profiles and extensive treatment history. This study aims to describe the effectiveness and safety of use of bedaquiline and delamanid for drug-resistant extrapulmonary TB.
Himani Mongia

EP01-106-21-Eliciting patient preferences for different attributes of a community-based model for management of multidrug-resistant TB in Uganda: a discrete choice experimentThe advent of all-oral regimens for the management of multidrug- resistant tuberculosis makes the implementation of home-based treatment a possibility for this group of patients. However, to be successful, options for home-based care should take into consideration patient preferences for different aspects of care.    
Stella Zawedde-Muyanja

EP01-107-21-Treatment of multidrug-resistant TB with modified shorter all-oral treatment regimen: Belarus operational research studyIn October 2018, Belarus started to use mSTR for multidrug-resistant tuberculosis under operational research conditions. By 1st May 2020, 415 patients were included in the study and, of them, 114 had final treatment outcomes with encouraging results (89% of treatment success).
Alena Skrahina

EP01-108-21-Patient’s perspective on drug-resistant TB medication: does it matter? Putting research into action to develop information, education and communication materialA qualitative study of drug-resistant tuberculosis (DR-TB) treatment from the perspective and experience of patient, family, healthcare worker and psychologist in six health facilities within three districts of Indonesia as a basis for developing DR-TB information, education and communication material based on the Health Belief Model and Transtheoretical Model.
Ferdiana Yunita

EP01-109-21-The role of clinical healthcare champions in driving drug-resistant TB policy implementation in South AfricaIn South Africa, champions have emerged as a driving force behind the implementation of decentralised management of drug-resistant tuberculosis (DR-TB). This study explored the typology of champions in the decentralisation of DR-TB management, strategies that champions used to implement policy and the contextual factors that enabled or hindered their agency.
Sacha Le Roux

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E-posters
EP09-Improved acceptability of TB regimens needed
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EP09-Improved acceptability of TB regimens needed
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

EP09-176-21-Risk factors for cycloserine neurotoxicity in patients treated for multidrug-resistant TBCycloserine has been re-classified as a category B drug by the World Health Organization. The neurotoxicity associated with cylcoserine has limited its use in treatment programmes. We systemically collected neurotoxicity data in patients in Cape Town treated with cycloserine, dosed as terizidone, for multidrug-resistant TB. We then evaluated factors, including cycloserine AUC, with neurotoxicity.
Richard Court

EP09-177-21-Hearing loss on second line injectable therapy for rifampin-resistant TB in a retrospective cohort in Worcester, South AfricaSecond line injectables (SLIs) remain a part of the drug-resistant TB regimen in many settings globally, even with SLI-induced ototoxicity rates remaining high. In this South African rifampin-resistant TB cohort, regimen adjustments due to hearing loss were common, further emphasising the need for access to SLI-sparing regimens.
Tara C Bouton

EP09-178-21-Treatment outcome of shorter regimen for multidrug-resistant TB in Pakistan 2018The National Tuberculosis (TB) Programme in Pakistan recommended a shorter regimen of nine-11 months in January 2018 under programmatic settings in all PMDT sites of the country. We compared treatment outcome of patients who were put on the shorter regimen, with those who were eligible for the shorter regimen but who were put on the longer one.
Abdul Ghafoor

EP09-179-21-From pilot to nationwide scale-up of shorter treatment regimen for drug-resistant TB treatment: lessons from NigeriaFollowing the adoption and rapid scale-up of GeneXpert as a primary tuberculosis (TB) diagnostic tool, limited bed spaces resulted in the challenge of a huge number of diagnosed drug-resistant TB (DR-TB) patients on treatment waiting lists. The CTB project facilitated nationwide scale-up of STR and NDs, including establishing aDSM for newly diagnosed DR-TB patients.
Sani Useni

EP09-180-21-Preferences for shorter regimens and child-friendly formulations for TB preventive treatment among families affected by TB in Lima, PeruFocus group discussions with families affected by tuberculosis (TB) in Lima, Peru, explored preferences for TB preventive treatment regimens, for both adult and child contacts, and sought to understand the drivers behind these preferences.
Courtney Yuen

EP09-182-21-Safety and efficacy of allogeneic γδ T cells for multidrug-resistant TB: an interim analysis of a prospective single centre, open labeled, non-randomised, controlled matched trialAnti-tuberculosis (TB) drugs for multidrug-resistant (MDR-TB) and rifampicin-resistant TB (RR-TB) currently encounter many obstacles and host-directed therapy approaches are now a focus for use as adjunct treatment options for shortening duration, limiting immunopathology, and improving outcomes. The safety and efficacy of γδT cells have been studied in our pilot trial, which is the first one worldwide.
Liang Fu

EP09-183-21-Interim outcomes of bedaquiline-containing regimen for the treatment of MDR/XDR-TB — a prospective cohort study from Hunan, ChinaChina introduced bedaquiline relatively late and little data exists on its use outside clinical trials. We conducted  a prospective cohort study to evaluate the effectiveness and safety of bedaquiline-containing regimen for 24 weeks intensive treatment of multidrug-resistant tuberculosis and extensively drug-resistant tuberculosis (MDR/XDR-TB) in Hunan province, China.
li shi

EP09-184-21-Treatment interruption patterns among patients on bedaquiline- containing regimen under programmatic conditionsThis was an observational study, including 275 consecutively enrolled tuberculosis (TB) patients, who received a bedaquiline-containing regimen under the national TB programme in India. The study analysed the reasons for interruptions of treatment and loss to follow-up and their effect on interim treatment outcomes during the first six months of treatment.
Rupak Singla

EP09-185-21-Incidence rate of linezolid adverse events among Myanmar adult MDR/RR-TB patients on individualised longer drug-resistant TB regimensLinezolid, a Group A drug, has evidences for significant treatment success but it also has common, serious adverse events such as myelosuppression and peripheral neuropathy. The study determined the incidence rate of linezolid adverse events and characterised the safety of linezolid among Myanmar adult multidrug-resistant and rifampicin-resistant tuberculosis (TB) patients who were on individualised, longer drug-resistant TB regimens.
Thandar Hmun

EP09-186-21-Real-time payment of Nikshay Poshan Yojana under direct benefit transfer scheme improved overall notification, treatment adherence and outcome of TB and DR-TB patients in Odisha, IndiaReal-time payment of Nikshay Poshan Yojana under a direct benefit transfer scheme improved the overall notification, treatment adherence and outcome of tuberculosis (TB) and drug-resistant TB patients in Odisha, India. The National TB Programme performance rank in the Odisha state went up from 27th to 15th during 2019.
Gayadhar Mallick

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Community Connect
Start, Stop and Continue: what needs to change so that communities are better supported to lead the charge on TB and co-morbidities during COVID-19
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Start, Stop and Continue: what needs to change so that communities are better supported to lead the charge on TB and co-morbidities during COVID-19
Available in English and French
This session takes place on Zoom.us

This practical and interactive debate will discuss solutions to how governments, the UN system and donors could work closer with community -led organisations and groups so that communities are better supported to lead the charge on TB and co-morbidities in the time of COVID-19. Session participants will discuss practical recommendations on what needs to start, stop and continue to make this happen.

Chair: 
Dr Khuat Thi Hai Oanh, Executive Director, NGO ‘SCDI, Vietnam, Southern Civil Society Organisations Alternate, Civil Society Engagement Mechanism for UHC2030 

Speakers: 
1. Ashim Chowla Chief Executive , Alliance India HIV/AIDS Alliance 
2. Dr Coulibaly OFFIA Madiarra, Executive Director of Alliance Cote D'Ivoire 
3. Andrey Klepikov, Executive Director, Alliance for Public Health, Ukraine 
4. Zahedul Islam
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Channel 7
SP-02-Tests for the detection of TB infection - tuberculin skin test vs interferon-gamma release assays
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SP-02-Tests for the detection of TB infection - tuberculin skin test vs interferon-gamma release assays
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There is no gold standard method for diagnosing tuberculosis (TB) infection. The World Health Organization (WHO) currently recommends a tuberculin skin test (TST) or an interferon-gamma release assay (IGRA) to test for TB infection to identify candidates for TB preventive treatment. This session reviews current WHO guidelines on who to test and critically reviews the related programmatic and implementation considerations. The pros and cons of current TB infection tests are discussed, including issues of supply. Finally, status of development and potential advantages and disadvantage of future tests for TB infection are addressed.

11:00 - 11:05: Introduction

11:05 - 11:15: Evidence and policy recommendations for testing for TB infection before TB preventive treatmentTuberculosis preventive treatment (TPT) should be selectively targeted to population groups at highest risk of progression to active disease. World Health Organization (WHO) guidelines strongly recommend TPT for adults and adolescents living with HIV and for children aged < 5 years who are household contacts of people with bacteriologically-confirmed pulmonary TB, if active TB is excluded. These groups should be given TPT even if TB infection testing is unavailable. However, for household contacts aged ˃= 5 years, confirmation of TB infection using IGRA or TST before starting TPT is desirable. Finally, systematic testing for TB infection and TPT is recommended for people who are initiating anti-tumor necrosis factor treatment, receiving dialysis, preparing for an organ or haematological transplant, or who have silicosis. It may also be done for prisoners, health workers, immigrants from countries with a high TB burden, homeless people and people who use drugs. In this presentation the WHO recommendations and underlying evidence are discussed.
Yohhei Hamada

11:15 - 11:25: Who to test: programmatic and implementation considerationsPartly as a result of testing availability and limitations in their accuracy, tuberculosis (TB) infection tests are not required prior to start of TB preventive therapy (TPT) in priority risk groups: people living with HIV (PLHIV) and household contacts aged less than 5 years. For other at-risk populations (household contacts 5 years and older and other high-risk groups), TB infection tests are generally recommended to identify those who would benefit most from treatment and to avoid unnecessary medication. However, implementation of TB infection tests is fraught with difficulties ranging from high cost, cold chain requirements (TST), short supply of quality-assured TST, to inadequate laboratory setup in undertaking high volumes of IGRA testing in decentralised settings where people need them. In this session the pros and cons of the requirement to test household contacts and HIV negative individuals before starting TPT are discussed, including risk-benefit considerations and programmatic implications.
Dick Menzies

11:25 - 11:35: TST vs IGRACurrently available tests for tuberculosis infection have major limitations. They have poor predictive value for development of active TB and do not indicate whether treatment of TB infection has been successful, which means that most people who have successfully completed what is considered an adequate course of preventive treatment will usually continue to have a positive test. IGRA needs sophisticated laboratory infrastructure and technical expertise as well as expensive equipment. TST is considered less resource intensive than IGRA but it requires a cold chain, two healthcare visits and needs training for intradermal injection and reading and interpretation and its quality control is a challenge. In the following presentations we present the true differences in the performance of these tests, but also the different roles these tests have in different settings.
Daniela Cirillo

11:35 - 11:45: Supplies of TST/IGRAGovernments and donors should invest and build health system capacity (human resources, logistics and supply chain and monitoring and evaluation) for TST and/or IGRA to avoid unnecessary TB preventive therapy, related harms and to improve acceptance. For TST this requires ensuring the availability and supply of tuberculin in cold chain as well as syringes, needles and consumables. IGRA tests have many infrastructural requirements (e.g. capacity of the laboratory system to conduct IGRA, including phlebotomy, processing of blood specimen, incubation and enzyme-linked immunsorbent assay (ELISA) reading) and are costly (unit test costs as well as need for laboratory infrastructure and laboratory personnel), making routine programmatic use in most low-and middle-income countries challenging. Supply of appropriate reagents and testing tubes for IGRA need to be ensured. However, having this capacity in place will also enable rapid adoption of any new TB infection test endorsed for programmatic use in future.
Brenda Waning

11:45 - 11:55: Future tests for TB infectionNew versions of TST and IGRA are expected to be launched in the immediate future, all using recombinant ESAT6-CFP10 antigens (C-Tb (Serum Institute of India, India), Diaskin Test (Generium, Russian Federation) and ESAT6-CFP10 test (Anhui Zhifei Longcom, China)) as well as point of care IGRA tests (Quantiferon Access and Standard E and F TB-feron tests from SD biosensor and the Advansure TB-IGRA test from LG Chem). Qiagen and SD Biosensor have both developed a simplified version of the IGRA that can be operated in peripheral facilities without laboratory infrastructures. These tests offer an incremental gain in ease of use or cost, or other operational aspects, but are not expected to provide major advantages in diagnostic test accuracy or predictive ability. In this presentation the status of development of new tests is presented, potential advantages and disadvantage of future tests for tuberculosis infection are discussed and remaining gaps are identified.
Morten Ruhwald

11:55 - 12:20: Q&A session

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OA-03-Optimising lung health beyond TB
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OA-03-Optimising lung health beyond TB
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11:00 - 11:05: Introduction


11:05 - 11:13: OA-03-514-21-Clinical predictors of outpatient child pneumonia mortality and development of a severity of illness score for outpatient care in rural Bangladesh – a multisite study Identifying children at higher risk of pneumonia mortality during outpatient care may improve outcomes. We explored clinical predictors of child pneumonia mortality and developed a predictive model applicable to outpatient care in rural Bangladesh.

Eric D McCollum

11:13 - 11:21: OA-03-515-21-Pneumococcal serotype epidemiology in Botswana following the introduction of 13-valent pneumococcal conjugate vaccine We endeavoured to describe temporal trends in pneumococcal serotype colonisation among children in Botswana following the introduction of the 13-valent pneumococcal conjugate vaccine (PCV-13). Understanding how the introduction of PCV-13 affects pneumococcal serotype epidemiology is essential to optimising the next generation of pneumococcal vaccines and reducing childhood mortality.

Sweta M. Patel

11:21 - 11:29: OA-03-516-21-Mycobacteria and other acid fast organism among presumptive pulmonary TB patients in Kaduna state, Nigeria Tuberculosis is a leading public health problem in Nigeria. Hence, there is a need for continuous characterisation of mycobacteria in order to obtain current data that will aid ongoing diagnosis and treatment. The aim of this study was to phenotypically characterise mycobacteria isolates recovered from patients with smear-positive samples.

Isiyaku Ahmadu

11:29 - 11:37: OA-03-517-21-A novel quantitative tool for rapid monitoring of Mycobacterium abscessus pulmonary disease treatment response Mycobacterium abscessus is the most common, rapid growing, non-tuberculous mycobacteria (NTM) causing NTM pulmonary disease (PD). A quantitative treatment monitoring tool has been developed to follow M. abscessus PD treatment response. This treatment monitoring tool does not require sample decontamination, with results available on the same day.

Daniela Alferes de Lima

11:37 - 11:45: OA-03-518-21-How does exposure to fine particulate matter in Malawi vary by gender, exposure source and cooking characteristics? Fine grain data from an ethnography-linked exposure study In low-income settings such as Malawi, continued use of biomass fuels for cooking causes frequent exposure to high levels of air pollution, strongly associated with a range of cardiorespiratory pathologies. We use personal exposure monitoring to describe differential PM2.5 exposures in this setting by gender, exposure source and cooking features.

Sepeedeh Saleh

11:45 - 11:53: OA-03-519-21-Pulmonary function testing and predictive equations in a healthy adult population in Mbeya, Tanzania Despite the increasing importance of spirometry in research projects as well as in clinical medicine, there is a lack of lung function reference values available for the African population. We conducted a cross-sectional study with 343 adults, in Mbeya, Tanzania, to obtain local predictive equations and compared them to GLI.

Rebekka Wenzel

11:53 - 12:01: OA-03-520-21-Availability of diagnostic services and essential medicines for non-communicable respiratory diseases in African countries The study aimed to explore the availability of diagnostic spirometry and essential medicines for asthma and COPD in African countries. Data was collected by a questionnaire given to attendees at PATS MECOR and IMPALA meeting. Primary data on availability was gathered and reasons behind the challenges of non-availability were explored.

Catherine Plum

12:01 - 12:09: OA-03-521-21-Chronic lung diseases remain under-prioritised in Africa despite their growing burden: findings from a lung health policy analysis Despite the growing burden of chronic lung diseases (CLDs) in Africa, investment in research, policy and programmes is lacking. Understanding regional and national-level lung health policy environments (via policy desk review and key informant interviews) is critical to inform generation, and effective, uptake of relevant and responsive lung health research.

Emma Heneine

12:09 - 12:20: Q&A


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OA-02-Finding a needle in the haystack: where are children with TB?
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OA-02-Finding a needle in the haystack: where are children with TB?
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11:00 - 11:05: Introduction


11:05 - 11:13: OA-02-507-21-Barriers to contact investigation among children: experience from Lagos, Nigeria The study explored the barriers to effective contact investigation among children from the health workers' perspective and found the need to address stigma, while also supporting health workers financially, to conduct contact investigation of index tuberculosis cases.

Oluremilekun Kusimo

11:13 - 11:21: OA-02-508-21-Low-level care facilities as entry points for peadiatric TB screening and case finding: a stepped-wedge randomised controlled study Using a stepped-wedge, randomised controlled study design, we enrolled children under five years, who had presumed TB, in health facilities in Cameroon and Kenya. We demonstrate high proportions of children diagnosed with presumptive and confirmed TB at lower-level care facilities, suggesting the utility of decentralised active case finding.

Rose Otieno-Masaba

11:21 - 11:29: OA-02-509-21-A simple clinical score for predicting active TB when same day microbiological testing is unavailable We developed and validated a simple clinical risk score for tuberculosis (TB) diagnosis among adults presenting to primary healthcare in sub-Saharan Africa. The score (ranging from 1-10) requires only readily accessible information in resource-limited settings. We identify score cutoffs where TB diagnosis has a high benefit-risk ratio when same day microbiological testing is unavailable.

Yeonsoo Baik

11:29 - 11:37: OA-02-510-21-Key clinical features among children under five with a presumptive or confirmed TB diagnosis in sub-Saharan Africa We described the clinical presentation of 203 children, aged under five, with a presumptive or confirmed tuberculosis (TB) diagnosis. Cough and fever were the most common symptoms overall. Adenitis, oedema and acute malnutrition were more frequent in children diagnosed with TB. Assessing malnutrition status should be a key component of paediatric TB screening.

Lise Denoeud-Ndam

11:37 - 11:45: OA-02-511-21-Using a mobile application to improve presumptive TB identification in children in western Kenya Tuberculosis (TB) is under-recognised in children globally. To evaluate the role of mobile health technology in facilitating paediatric TB screening, we implemented a presumptive paediatric TB mobile application in a rural hospital in western Kenya. Following roll-out, there was an increase in the proportion of children identified in presumptive TB registers.

Dylan Peterson

11:45 - 11:53: OA-02-512-21-Protecting our children from active TB disease: expanding TB preventive therapy in nine sub-Saharan countries Using a pre- and post-intervention design, we demonstrate a significant increase in the initiation of tuberculosis preventive therapy (TPT), following the introduction of intensified household contact investigation and linkage to care for children eligible for TPT, in routine clinical settings across nine sub-Saharan countries.

Jean-Francois Lemaire

11:53 - 12:01: OA-02-513-21-Challenges and solutions in the recruitment of children to a multidrug-resistant TB prevention trial: early experiences from TB-CHAMP TB-CHAMP is a randomised, placebo-controlled trial to assess the efficacy of fluoroquinolone preventive therapy in young children exposed to an adult with multidrug-resistant tuberculosis. Recruitment to randomised clinical trials can be challenging and lessons learned from TB CHAMP will be relevant to other current, and future, research efforts.

Susan Purchase

12:01 - 12:20: Q&A


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SP-01-Strengthening evidence on optimal treatments for multidrug-resistant TB: approaches to studying timing and duration.
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SP-01-Strengthening evidence on optimal treatments for multidrug-resistant TB: approaches to studying timing and duration.
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Treatment for multidrug-resistant tuberculosis (MDR-TB) is characterised by prolonged duration and frequent toxicity. While injectable-free and shortened regimens represent enormous improvements, critical knowledge gaps remain about optimal treatment for MDR-TB. Among them are the comparative effectiveness of all-oral shortened regimens; the exposure-toxicity relationship in dynamic multidrug regimens; the optimal duration of treatment and of individual drugs and the choice and timing of endpoints used for each. This symposium will highlight challenges in the study of these questions, both in the clinical trial and observational study settings, and will offer practical approaches for improving valid inference.

11:00 - 11:05: Introduction

11:05 - 11:15: Follow-up duration in study of treatment of different durations: bias and implicationsA major concern about shortened regimens is possible increased recurrence (relapse and reinfection) after treatment completion. Documented, systematic post-treatment follow-up is critical to accurately assess efficacy of shortened regimens compared to longer control regimens.  Failure to systematically follow patients in observational or experimental studies can result in underestimated recurrence after shortened regimens. Follow-up time for equivalent durations after treatment completion (e.g. six months after a nine-month regimen and after an 18-month control) can result in the same overestimate, which can bias the effect estimate. For that reason, guidance recommends defining total follow-up duration from the point of randomisation, e.g. 24 months after randomisation. Effectively, this results in 15 months post-treatment follow-up for a nine-month regimen and six months for an 18-month regimen. This could overestimate recurrence in shortened regimens relative to controls and lead to bias. This talk will explore these biases and their implications for guidelines and programmatic decision making.
Gerry Davies

11:15 - 11:25: Short, long, or somewhere in between? Designing clinical trials to identify the optimal duration of therapyClinical development of new regimens for the treatment of tuberculosis (TB) involves not only the selection of the right drugs and doses, but also a choice of the optimal duration of therapy that maximises efficacy, while not exposing patients to a longer duration of potentially toxic drugs than necessary. Different approaches have been considered to generate evidence to support this choice with varying success. bedaquiline and delamanid have been evaluated in clinical trials and approved for the treatment of TB, but we are still learning the optimal duration of each. In this presentation, I will talk about the latest clinical trial designs that are being applied in drug-susceptible TB and drug-resistant TB randomised trials to efficiently identify optimal durations of new regimens. I will talk about the duration-randomised design which involves modelling of the duration-response relationship, proving a case study of how this has been applied in a planned TB trial.
Patrick Phillips

11:25 - 11:35: Does prolonged use of bedaquiline improve treatment outcomes? An application of methods to study optimal treatment duration using observational dataIn observational research, a common approach to studying the effect of treatment duration entails categorising patients according to the duration of their regimen (e.g. <15 months; 15-20 months, >20 months) and comparing the frequency of treatment success in patients with longer and shorter regimens. Results derived from this approach may be biased in favour of longer treatment because patients who survive longer can receive longer treatment. On the other hand, results may be biased against longer treatment if patients receive longer treatments due to a slower treatment response or treatment-emergent toxicities that then limit subsequent treatment options. To overcome these potential biases, we employ an alternative approach that emulates a randomised trial in which each individual is randomly assigned to a treatment duration. We provide an illustrative example in which we compare the effects of bedaquiline for 24 weeks, 48 weeks or the entire duration of treatment on end-of-treatment outcomes.
Molly Franke

11:35 - 11:45: Methodological challenges in analysis and reporting of sputum culture conversion endpoints in observational treatment cohortsIn observational multidrug-resistant tuberculosis treatment cohorts, time-to-sputum culture conversion (SCC) or SCC at specified time-points since treatment initiation (e.g. six months), are commonly used as interim endpoints for end-of-treatment outcome. While World Health Organization definitions for SCC exist, there is substantial heterogeneity in how these definitions are operationalised given varying data collection practices, monitoring schedules and laboratory procedures across cohorts. We will discuss the potential for selection bias due to the use of prolonged periods to establish patients’ baseline culture in SCC cohorts. We will describe the current state defining baseline sputum culture in the literature and recommend best practices for avoiding or resolving this bias.
Carly Rodriguez

11:45 - 11:55: How best to analyse and report adverse events occurring during multidrug-resistant TB treatment?Is the new regimen safe? This is a priority question in the evaluation of new multidrug-resistant TB regimens. Adverse events reporting is critical to evaluate regimen safety. However, drawing conclusions from observational adverse event data is challenging in the context of dynamic regimens. Important considerations include causality attribution in the context of regimens with multiple drug stops and stops; determining the dates of event onset and drug exposure; and adverse event recurrences. In this talk, we will detail methodological challenges to the analyses and reporting of adverse event data and provide illustrative examples using data from the End TB observational study. 
Mathieu Bastard

11:55 - 12:20: Q&A session

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OA-04-A holistic approach: experiences from Europe
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OA-04-A holistic approach: experiences from Europe
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11:00 - 11:05: Introduction


11:05 - 11:13: OA-04-522-21-“You have to adjust your whole life.” Interconnected, dynamic influences on adherence to treatment for TB among adults in three UK cities Non-adherence to tuberculosis (TB) treatment has significant implications for individual patients and for efforts to end TB. A better understanding of how factors affecting the non/adherence intersect can guide development of patient-centred, cost-effective measures to improve treatment taking. We report on in-depth interviews with individuals on TB treatment in the United Kingdom.

Aaron S Karat

11:13 - 11:21: OA-04-523-21-Doubling TB preventive treatment enrolment rates among people living with HIV in Ukraine Under the United States Agency for International Development funded Challenge TB (CTB) mechanism, PATH used a data-driven, evidence-grounded advocacy approach to shift the management of tuberculosis (TB) preventive treatment (TPT) services for people living with HIV (PLHIV), in Donetsk Oblast, from TB doctors to HIV specialists. This shift led to a doubling of PLHIV initiated on TPT.

Olga Pavlova

11:21 - 11:29: OA-04-524-21-Providing incentives and enablers to support people suffering with TB completing their treatment in Belgium: a successful approach In Belgium, tuberculosis (TB) treatment completion remains challenging, especially among the most vulnerable groups, such as the homeless or people living in irregular situations. Since 2015, a joint project between the Belgium TB Programme and non-governmental organisation, has looked to provide incentives and enablers, including shelters, to improve treatment outcomes.

Lilas Weber

11:29 - 11:37: OA-04-525-21-Video observed treatment for TB patients in Belarus In Belarus, with the Global Fund’s support, a pilot video-observed treatment (VOT) project was expanded across the country in October 2016. VOT for tuberculosis patients in Belarus, used at programmatic level, demonstrates high levels of patient acceptability and excellent treatment outcomes.

Alena Skrahina

11:37 - 11:45: OA-04-526-21-ART prescription by TB doctors in Odeska oblast, Ukraine: successful model of integration of services for patients with TB-HIV co-infection In Ukraine, only HIV specialists are permitted to prescribe antiretroviral treatment (ART), which leads to delayed initiation and low ART coverage among tuberculosis (TB) patients. The United States Agency for International Development funds the Challenge TB Project and its support has enabled TB doctors to prescribe ART. This resulted in a significant increase of ART coverage and reduction of ART initiation delays.

Olga Pavlova

11:45 - 11:53: OA-04-527-21-Results of pilot of integrated diagnosis of TB and hepatitis C among HIV-positive incarcerated individuals using GeneXpert in Dnipropetrovska oblast of Ukraine Usage of GeneXpert opportunities as an integrated patient-oriented approach for TB and hepatitis C virus diagnosis, and HIV viral load determination, among detainees and prisoners in Dnipro Penal Institution №4, in Ukraine, greatly reduces turnaround times and improves efficiencies while also increasing access to services for prisoners and detainees.

Svitlana Leontieva

11:53 - 12:01: OA-04-528-21-COVID-19-TB and multidrug-resistant TB co-infection in Belarus Belarus, a high burden multidrug-resistant TB country, had a total of 22,973 confirmed COVID-19 cases on May 10th. Measures to monitor COVID-19-TB patients prospectively, in the countrywide cohort, were developed. Our data will help create a global database for the subsequent generation of evidence-based recommendations to combat both infections. 

Alena Skrahina

12:01 - 12:20: Q&A


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OA-01-TB preventive therapy in HIV
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OA-01-TB preventive therapy in HIV
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11:00 - 11:05: Introduction


11:05 - 11:13: OA-01-500-21-Isoniazid preventive therapy interruptions and TB among people living with HIV in the Democratic Republic of the Congo Isoniazid preventive therapy (IPT) is a critical prevention intervention for people living with HIV (PLHIV) in high tuberculosis (TB) burden settings, such as the Democratic Republic of the Congo. However, isoniazid shortages result in frequent IPT interruptions among PLHIV. We analysed data from the integrated HIV/AIDS project in Haut Katangato to understand potential impact of isoniazid interruptions.

Ibou Thior

11:13 - 11:21: OA-01-501-21-The effect of antenatal isoniazid preventive therapy on birth outcomes in western Kenya Isoniazid preventive therapy (IPT) reduces risk for tuberculosis (TB) disease in people living with HIV and AIDS. However, there is conflicting data on maternal IPT safety in pregnancy related to birth outcomes. We evaluated programmatic data in Kisumu, Kenya, to assess birth outcomes among women with, and without, antenatal IPT exposure.

Elizabeth Quincer

11:21 - 11:29: OA-01-502-21-Birth outcomes of pregnant women exposed to isoniazid preventive therapy Tuberculosis (TB) is associated with increased risk of death and morbidity among HIV-positive pregnant women. Antiretroviral therapy and isoniazid preventive therapy can reduce mortality rates among HIV-positive pregnant women in high burden settings. Findings suggest that IPT can be safely used during the second and third trimester of pregnancy.

Sikhethiwe Masuku

11:29 - 11:37: OA-01-503-21-Isoniazid preventive therapy added to ART to prevent TB disease: an individual participant data meta-analysis Isoniazid preventive therapy (IPT) prevents tuberculosis (TB) in people living with HIV (PLHIV). We conducted an individual, participant data meta-analysis of randomised controlled trials to estimate the effect of IPT with antiretroviral therapy to prevent TB and death among PLHIV across subgroups by sex, CD4 count and immune sensitisation to TB.

Jennifer Ross

11:37 - 11:45: OA-01-504-21-Impact of TB preventive therapy on TB incidence among persons living with HIV receiving antiretroviral therapy in Nairobi, Kenya (2015–2019) People living with HIV (PLHIV) have a high tuberculosis (TB) comorbidity rate. TB preventive treatment (TPT) significantly reduces TB incidence among PLHIV. We analysed five-year, HIV programme data to determine TB incidence and relative risk among PLHIV who did or did not receive TPT.

Herman Weyenga

11:45 - 11:53: OA-01-505-21-Comparing IsoScreen results and self-reported isoniazid preventative therapy adherence among HIV-positive pregnant women in South Africa This abstract describes a comparison of self-reported, isoniazid preventative therapy adherence (IPT) and adherence as measured by the IsoScreen urine test, among HIV-positive women who initiated IPT during the iThamby study, at six sites in three provinces of South Africa.  The IsoScreen test was conducted across multiple study visits.

Tebogo Sole

11:53 - 12:01: OA-01-506-21-Suboptimal adherence to isoniazid preventive therapy using urine biomarker assessment in children living with HIV: association with viral suppression and age Children living with HIV (CLHIV) are more susceptible to tuberculosis (TB) infection and disease. With optimal adherence, isoniazid (INH) preventive therapy (IPT) reduces the risk of TB by 60%. We assessed adherence to IPT in a prospective cohort of 100 CLHIV using caregiver or child self-report pill counts and urine INH biomarkers.

Dickens Onyango

12:01 - 12:12: Q&A


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OA-05-Innovative TB diagnostics
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OA-05-Innovative TB diagnostics
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12:30 - 12:35: Introduction


12:35 - 12:43: OA-05-529-21-Correlation of high-sensitivity C-reaction protein, Gene Xpert and urine LAM test for TB diagnosis in HIV-positive Kenyan patients within DREAM programme The objective of the present study is to improve tuberculosis (TB) diagnosis among HIV-positive patients using HS-CRR, LF-LAM test, 4SS and Gene Xpert. Five hundred and seventy eight Kenyan, TB-suspected patients were enrolled. Diagnosing TB infection in HIV-positive patients remains challenging, as concordance with clinical screening and different tests is suboptimal.

Fausto Ciccacci

12:43 - 12:51: OA-05-530-21-Purification of lipoarabinomannan from urine of patients with TB A multistep approach to extract urinary lipoarabinomannan (uLAM) from patients with tuberculosis (TB) and which can be scaled to use on large specimen volumes, was developed and assessed. The resulting uLAM will be used to support generation and screening of new uLAM antibodies that may increase the sensitivity of TB LAM assays.

Jason Cantera

12:51 - 12:59: OA-05-531-21-Sequence-specific hybridisation capture of urine cell-free DNA to diagnose pulmonary TB We have developed a highly-sensitive hybridisation capture assay for improved detection of TB-specific, cell-free DNA in urine. We present the results of clinical testing of our assay in urine from HIV-infected and HIV-uninfected adults with, and without, pulmonary tuberculosis in South Africa and in healthy controls in the United States. 

Amy Oreskovic

12:59 - 13:07: OA-05-532-21-Correlation between the metabolic urine profile using nuclear magnetic resonance spectrometer and the standardised case definitions for the diagnosis of childhood TB Surveillance during treatment is essential to monitor adherence and treatment response. In this proof of concept we identified a urine metabolic profiling, based on nuclear magnetic resonance of drug-sensitive pulmonary tuberculosis (TB) patients, that can identify individuals who have received treatment and changes over the course of TB treatment.

Patricia Comella-del-Barrio

13:07 - 13:15: OA-05-533-21-A novel urine method for the diagnosis of active pulmonary TB by immunoassay for the detection of ESAT-6 using hydrogel nanoparticles in HIV patients In HIV patients, tuberculosis (TB) diagnosis is difficult. A new test in urine - using hydrogel nanoparticles (NIPAm) with reactive blue - is proposed, allowing capture, preservation and concentrating ESAT-6. NIPAm are N-isopropylacrylamide copolymers, which capture and protect from enzymatic degradation. A new method for diagnosing active pulmonary TB was evaluated by immunoassay.

Raquel Mugruza

13:15 - 13:23: OA-05-534-21-Similarity algorithm for chest X-ray images: testing on large, annotated TB patient cohort and implementation of database search service We evaluated strategies for chest X-ray similarity calculation from radiomic features for application to the large, annotated image dataset in the NIAID Tuberculosis Portals (TBP). With increasingly large and well-annotated clinical image datasets, image retrieval through image similarity may help physicians identify similar patient cases with useful context for clinical care.

Conrad Shyu

13:23 - 13:31: OA-05-535-21-Diagnosis of TB through exhaled, volatile organic compounds using a real-time, high-pressure photon ionisation time-of-flight, mass spectrometry Early and accurate diagnosis and detection of tuberculosis (TB) is essential for achieving global TB control. More accurate, rapid and cost-effective screening tests are needed to improve case detection and treatment evaluation. Due to the non-invasive nature and the possibility to sample continuously, exhaled breath analysis has great clinical potential.

Liang Fu

13:31 - 13:50: Q&A


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SP-06-The people-centred framework for national and subnational TB planning and programming: early adopters share lessons learned and experiences
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SP-06-The people-centred framework for national and subnational TB planning and programming: early adopters share lessons learned and experiences
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In the era of the End TB Strategy, the Sustainable Development Goals, and recent COVID-19 pandemic, national tuberculosis (TB) programmes are under increasing pressure to balance demands for ambitious programme targets with limited/diminishing resources. The resulting requirement for prioritisation and 'hard choices' threatens to curtail effective TB programming. Rwanda, Uganda and Ethiopia, early adopter countries, share their experiences applying the people-centred framework in their latest NSP development. The people-centred framework was designed to help countries to better streamline and utilise increasingly available evidence/data for decision making along the care continuum (including utilisation of mathematical impact and cost-effectiveness modelling), and facilitate evidence-based, optimised, people-centred responsive and resilient strategic planning and programming.

12:30 - 12:35: Introduction

12:35 - 12:47: Introduction to the people-centred framework for TB planning and programmingThe people-centred framework (PCF) for tuberculosis (TB) programming encourages us to rethink our approach to analysis, planning, implementation and evaluation of TB programmes. The presentation will introduce the philosophy, concept, approach, elements and some initial experiences (when and how to employ it). A future is envisioned in which evidence is reviewed and analysed in a patient-centred manner. Priority gaps are identified and closed ensuring access for all to high-quality services for prevention, diagnosis, treatment and care of TB, including post-treatment follow-up care. Data consolidation along the TB care continuum, impact optimisation of interventions, subnational validation and health service delivery optimisation form the four cornerstones of the PCF-based national strategic plan (NSP) 2.0. PCF will help countries to decide how best to allocate resources and use pre-populated data and automated data visualisations to continuously and critically assess the performance of TB-NSP implementation.
Emmy van der Grinten

12:47 - 12:59: Using the people-centred framework for national strategic plan development while on lockdown due to COVID-19The COVID-19 pandemic and lockdown to mitigate spread impacted the finalisation of the national strategic plan (NSP) and development of the NSP-based TB & HIV combined Global Fund funding request. Under unprecedented circumstances, how did Rwanda manage to adopt the people-centred framework (PCF), data consolidation and visualisation along the care continuum and TIME modelling, to support prioritisation and optimisation, before the lockdown? And also a patient pathway analysis to assess the alignment of care-seeking and service availability, with distant support from consultants due to international travel restrictions? Plus the intervention package scenarios to compare budget to best impact and the GFFR development, with a mix of in-country and distant TA? Patrick Migambi will share challenges, experiences, creative solutions and lessons learned.
Patrick Migambi

12:59 - 13:11: Developing an evidence-informed national strategic plan using epidemiological, people-centred and systems-related dataUganda is one of the early adopter and approach shaper countries for the people-centred framework for tuberculosis (TB) programming. The development of the Uganda national TB strategic plan (2020/21-2024/5) employed a patient-centred approach and was informed by the evidence gathered through a data consolidation process along the TB care continuum. The process included a patient pathway analysis (PPA) that was carried out to assess the alignment between country-level service provision and initial care-seeking by the population. Data was consolidated into an excel tool with automated data visualisations based on key performance indicators that provided evidence on epidemiology, people and systems. The evidence generated provided a basis for problem identification, prioritisation, root cause analysis, intervention identification and optimisation. 
Stavia Turyahabwe

13:11 - 13:23: Developing an optimised national strategic plan using TIME Impact & TIME EconomicsEthiopia, under the now ending national tuberculosis strategic plan, has made significant strides to achieve the End TB goals. By the end of 2018, 96% of public hospitals and health centres; 71% of private hospitals; 6.5% of private specialised clinics; and 22% of private medium clinics were providing TB diagnostic and/or treatment services. However, the country still remains among the top 30 high TB, TB-HIV and multidrug-resistant TB burden countries, and over a third of estimated 165,000 TB cases were missed in 2018. The country’s TB programme had about 60% funding gap in 2018. In an effort to address the remaining challenges, we analysed policy, programmatic and implementation gaps and did root cause analyses using the people-centred framework (PCF). We combined our in-house modelling capacity with support form external consultants to develop an optimised national strategic plan. We share our experience with the PCF approach with particular focus on TIME Impact and TIME Economics modelling.
Taye Letta

13:23 - 13:50: Q&A session

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SP-05-Updating World Health Organization TB screening guidelines: evidence reviews of the yield, tools and costs of screening
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SP-05-Updating World Health Organization TB screening guidelines: evidence reviews of the yield, tools and costs of screening
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In order to achieve the targets for the World Health Organization's (WHO's) End TB strategy and for the United Nation's High-Level Meeting for diagnosing and treating people with tuberculosis (TB), there is an urgent need to deploy strategies to improve TB case detection. One such strategy is systematic screening for TB. To help facilitate implementation at the country level, the WHO is currently updating the guidelines on systematic screening for TB, for which systematic reviews have been conducted of the current landscape and yield of screening activities, the performance of screening tools, approaches for screening in children and the costs and cost-effectiveness of screening.

12:30 - 12:35: Introduction

12:35 - 12:45: Overview and systematic review of the number needed to screen for active TBOne of the pillars of the World Health Organization End TB strategy is to increase early diagnosis of tuberculosis (TB) through implementing systematic screening programmes for high-risk groups. Active case finding (ACF) is a useful tool for targeted screening and has been shown to reduce time to TB detection, TB incidence and mortality. This presentation will review results of a systematic review undertaken to evaluate and synthesise the existing body of evidence that has been collected about ACF to assess the number needed to screen (NNS) in order to detect one case of active TB. Specific outcomes assessed include 1) the average NNS in order to detect one case of active TB, 2) the average NNS for high-risk groups (including prisoners, pregnant women, persons with diabetes, drug users, healthcare workers and others, and 3) how different screening tools (including symptom screening, CXR, Xpert, and others) affect NNS.
Lelia Chaisson

12:45 - 12:55: Performance of symptoms and chest radiography as screening tools and choosing algorithms for screening for active TBThe accuracy of screening tools, in combination with confirmatory testing, determines the performance and yield of a screening programme and the burden on individuals and the health service. Symptom questioning and chest radiography (CXR) have been the most widely available screening tools used to date. We conducted a systematic review to assess the sensitivity and specificity of symptom screening and chest radiography for detecting bacteriologically-confirmed active pulmonary TB, assessing potential sources of heterogeneity. To inform disease control programmes about the choice of appropriate screening and diagnostic tools for tuberculosis (TB) screening, we compared the performance of a range of screening algorithms in decision analytical models, assessing the yield, number needed to screen (NNS), positive predictive value, and resource implications (cost per true case detected and individual screened) for different TB epidemiological and population settings.
Anja van’t Hoog

12:55 - 13:05: Computer aided detection solutions for pulmonary TB: what is their performance in screening and diagnostic triage settings?The tuberculosis (TB) field welcomed several computer aided detection (CAD) products that provide an automated, standardised interpretation of a digital chest X-ray (CXR). CADs generate an abnormality score that can be used to identify individuals requiring further diagnostic testing.
FIND established an archive of CXRs from various data sources with representation of different geographical origin, high and low TB risk groups from screening and triage settings. The archive, housed at an offline facility, contains images that were not used for training of any of the CADs and is used to assess the accuracy of CAD4TB (Delft Imaging), Lunit Insight CXR (Lunit Insight) and qXR (Qure.ai) for their ability to detecting pulmonary abnormalities suggestive of TB compared against a microbiological, human radiologist and composite reference standard.
In this talk, accuracy is presented for each CAD and the consequences for their use as screening or triage tool will be discussed.
Sandra Kik

13:05 - 13:15: Screening tests for active pulmonary TB in children: systematic reviewCase finding is a crucial step in the cascade of care for patients with tuberculosis (TB). However, in many children the disease is never diagnosed. National and international recommendations for child health generally lack guidance on systematic screening strategies for TB. This presentation will share findings from a recently conducted systematic review and meta-analysis assessing the accuracy of several screening strategies for child TB, including various symptoms and symptom combinations, chest radiography, Xpert MTB/RIF, Xpert Ultra, and combinations of these tests. This review focuses on screening of children and adolescents up to 19 years old in high-risk groups - including contacts of persons with TB, children living with HIV and children with pneumonia. Implications of these findings will be discussed.
Bryan Vonasek

13:15 - 13:25: Costs and cost-effectiveness of TB screening: systematic reviewThe presentation will include key results from a systematic review of the published literature on economic evaluations for tuberculosis (TB) screening, including active and intensified case finding with a particular focus on the following tools: symptom screens (prolonged cough and any symptom), chest X-ray (CXR) and CXR using automated detection such as CAD4TB, and GeneXpert MTB/RIF and Xpert Ultra. We included studies that compared these TB screening approaches to standard case detection and looked at study outcomes, including numbers of cases detected and impact on TB epidemiology in a community. We will present current economic evidence and key costs, cost-effectiveness results and discuss affordability of these screening approaches. We will also present results among high-risk populations, such as people living with HIV, migrants, prisoners and people with diabetes.
Hannah Alsdurf

13:25 - 13:50: Q&A session

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Channel 7
SP-07-Towards new TB vaccines: progress and considerations for introduction
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SP-07-Towards new TB vaccines: progress and considerations for introduction
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The World Health Organization End TB strategy aims to end the tuberculosis (TB) epidemic by 2035. A new TB vaccine that is safe, affordable and effective in providing protection against all forms of TB in adolescents and adults is critical for rapidly reducing disease incidence and mortality. There are currently promising candidates in the clinical pipeline. However, accelerating progress requires a globally coordinated plan to efficiently streamline the complex approaches to testing and the introduction of new vaccines. This symposium aims to discuss current evidence around the full benefits new vaccines offer, as well as venues needed to accelerate development and to facilitate programmatic implementation.

12:30 - 12:35: Introduction

12:35 - 12:47: World Health Organization preferred product characteristics for preventive and therapeutic vaccinesThis presentation outlines the World Health Organization's (WHO’s) preferred and minimal product characteristics (PPCs) for both preventive and therapeutic vaccines. These PPCs intend to articulate attributes of products, that are suitable for end users, to scientists, funding agencies and industry groups developing TB vaccine candidates intended for WHO pre-qualification and policy recommendations
Ann Ginsberg

12:47 - 12:59: The clinical development pipeline of new TB vaccinesThis presentation will summarise the progress in the clinical development pipeline of new tuberculosis (TB) vaccines and the prospect for their availability and use in countries that need them most. Considering that vaccines potentially offer a novel approach to combat emergence and transmission of anti-TB resistance, this session will also seek to inform the debate on the use of new vaccines in settings with high level of resistance.
Dereck Tait

12:59 - 13:11: A global roadmap for the research and development of new TB vaccinesThis presentation will share findings from the development of a global roadmap for the research and development of new tuberculosis (TB) vaccines, which was launched in 2020. The roadmap articulates elements of need across the clinical development, delivery and implementation of new TB vaccines in the form of research questions, as well as capacity needs with an end-to-end perspective. Crosscutting challenges and opportunities at the scientific, financial, policy, regulatory, manufacturing and access interface will be discussed in this presentation.
Frank Cobelens

13:11 - 13:23: Assessing the full value of new TB vaccines for decision-makingThe introduction of a new vaccine into national immunisation programmes often involves a trade off with investing in other vaccines or alternative strategies. As such, countries need broader information for assessing the comparative health and economic impact of new vaccines before implementation. I will share an update on progress in a project designed to assess the potential health and economic impact of new tuberculosis (TB) vaccines, using various vaccine characteristics and implementation scenarios. The intended goal is to proactively prepare evidence necessary for decision-making by countries, partners and institutions involved in new TB vaccine development and implementation.
Richard White

13:23 - 13:50: Q&A session

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SP-04-Advancing TB prevention in children during the COVID-19 pandemic
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SP-04-Advancing TB prevention in children during the COVID-19 pandemic
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If resources are diverted away from child and adolescent tuberculosis (TB) programmes in order to fight COVID-19, consequences in resource-limited settings could be devastating. TB prevention is more important than ever but better strategies need to be developed and applied to deliver proven interventions for child TB contact management (CCM), TB preventive treatment (TPT) and BCG vaccination to newborns in the context of COVID-19. We will engage stakeholders by discussing early experiences of globally adapting CCM, TPT and BCG delivery during the COVID-19 pandemic. Sharing experiences is essential to identifying feasible and safe strategies that assist in maintaining essential TB prevention services.

12:30 - 12:35: Introduction

12:35 - 12:45: Overview of TB prevention services in children and adolescentsIn this talk, we will present a policy overview and coverage of tuberculosis (TB) prevention services among eligible children and adolescents. We will share reports from regional and country colleagues as well as partner organisations on the effect of COVID-19 on TB prevention services.
Annemieke Brands

12:45 - 12:55: The effect of COVID-19 on childhood TB preventive treatment services in sub-Sahara Africa: experiences from CaP TB projectContact investigation and delivery of tuberculosis preventive treatment (TPT) are World Health Organization-recommended core components of childhood TB programming. Between Q4 2018 and Q1 2020, the CaP TB project has supported facility-based implementation of those interventions in purposely selected sites across nine African countries. As of March 2020, project countries have started enforcing measures aimed at controlling the COVID-19 pandemic, with repercussions on accessibility to health services that varied among countries. This presentation will discuss the effect of COVID-19 control measures and interventions on delivery and accessibility of contact investigations and TPT services, as documented by key patient level indicators collected through the project framework for monitoring and evaluation. It will also discuss the effectiveness and feasibility of mitigation measures introduced to ensure continuation of those essential TB prevention services in the context of the COVID-19 pandemic.
Martina Casenghi

12:55 - 13:05: Impact of COVID-19 on 3HP rollout: experiences from IMPAACT4TBProvision of tuberculosis preventive therapy to household child contacts and people living with HIV is a key component of the END TB strategy. The IMPAACT4TB project was scheduled to begin roll out of 3HP, a new short-course TB preventive therapy regimen, in 12 high burden countries in March 2020 as the COVID-19 pandemic was beginning to unfold. As countries developed their COVID-19 response, there have been large ramifications for healthcare delivery, including contact investigations and TB prevention services. We will discuss mitigation measures and alternative models of care that have been implemented to ensure these services have continued during the COVID-19 pandemic response.
Nicole Salazar-Austin

13:05 - 13:15: Flexible child contact management frameworkThe World Health Organization roadmap for childhood tuberculosis recommends an ‘integrated, family and community-centred strategy’. Yet, there is no clear guidance on how health systems can operationalise such a strategy. it is crucial to recognise that barriers that impede successful child contact management (CCM) vary from family to family, even within the same community. COVID-19 further complicates delivery of CCM during the pandemic and recovery periods. We propose a flexible CCM framework, which goes beyond standardised approaches. Suggestions will be provided on how health systems could support a framework that is customised for each child’s/family’s needs as well as their varied environments.
Yael Hirsch-Moverman

13:15 - 13:25: Responsible use of BCG in the context of COVID-19 pandemicBacille Calmette-Guérin (BCG) vaccines are live vaccines (different strains) that have been used to protect mainly young children against severe forms of tuberculosis (TB) in high TB burden settings for many years. Recent BCG stock-outs emphasised its importance when TB meningitis cases soared among unvaccinated children. BCG’s effect on the immune system is not fully understood, but it has an immune modulating effect, which extends its use beyond TB prevention, e.g. it has proven value in treating non-invasive bladder cancer. A recent ecological study showed an association between lower mortality in COVID-19 cases and BCG coverage. However, this does not prove causality. Clinical studies are now being done to determine whether BCG protects against COVID-19 and likely other respiratory infections. We will provide an update on this topic.
H. Simon Schaaf

13:25 - 13:50: Q&A session

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SP-03-When novel product bans are best: lessons learned and challenges faced in tackling tobacco in low-and middle-income countries.
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SP-03-When novel product bans are best: lessons learned and challenges faced in tackling tobacco in low-and middle-income countries.
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The debate on novel products (e-cigarettes and heated tobacco products) wages on. It has been both contentious and also somewhat myopic, focusing on electronic nicotine delivery systems (ENDS) potential utility — or lack thereof — as a harm reduction tool in developed countries. This session will expand the discussion, providing a much needed spotlight on low-and middle-income countries; many have decided that absent sufficient regulatory framework and new product sales bans are critical to tobacco control — and protecting youth. Experiences will be shared from India, Indonesia, Viet Nam and Mexico.

12:45 - 12:50: Introduction

12:50 - 13:03: Mexico: industry attempts to influence governmentSince its latest iteration, stemming from the 2003 patent, vaping has transformed from a hobbyist movement to a rapidly growing industry. Headed by the big tobacco companies, along with the new specialised companies and 'users' groups, this new industry is not shy about using all the tools developed by the tobacco companies to achieve a legal and social situation that favours their interests. A prolific marketing effort, legal trials, alliances with legislators, sponsored scientific articles, news and media inserts, and public attacks on those who do not share their position are just some of the methods used, magnified through the use of social networks. In Mexico these efforts has been stronger in the last two years, since the ban turned 10 years of being imposed, and the products of large tobacco companies (BAT's Vype and PMI's IQOS) have been illegally introduced to the Mexican market.
Inti Barrientos-Gutierrez

13:03 - 13:16: Reflections on the one year anniversary of the banIn September 2019, India announced a federal ban on the production, import and sale of e-cigarettes, noting that these products are harmful to health. This session will describe decisions and factors leading to the ban and outline any issues that emerged—either in support of, or in opposition to, the ban. It will also describe progress and challenges faced over the year-long period since the ban was announced and detail gaols for the next year.
Leimapokpam Swasticharan

13:16 - 13:29: Making the case: where sales bans are bestCatlin Rideout and Megan Quitkin are both deputy directors at The Union, which released its electronic nicotine delivery systems (ENDS) and heated tobacco products (HTPs) position paper in advance of World No Tobacco Day 2020. In this session, they will provide context for the 2020 position paper, explaining why The Union felt the need to outline the arguments towards bans. They will also provide specific context about low-and middle-income countries, explaining why the economic conditions and advanced tobacco epidemics in these countries necessitate banning ENDS as critical to child protection and ensuring no further escalation of the tobacco epidemic.
Ayu Swandewi Astuti

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P1-Prevention supports cure
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P1-Prevention supports cure
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Historically TB services and approaches have focused on finding and treating people who have active TB disease, who may be at risk of transmitting TB to their immediate contacts and community. However, there are tools that have been available to TB programmes for a number of decades that can prevent TB disease – TB vaccine and TB preventative therapies. Yet, despite these preventative tools, 10 million people a year still develop TB disease.
This plenary will discuss how TB prevention tools continue to improve and how to ensure that as new tools are developed the appropriate health system strengthening and policies on Universal Health care can be undertaken so they are implemented without compromising the treatment and care of TB disease.

14:00 - 14:03: Session introduction


14:03 - 14:18: P1A-Vaccines: 100 years since BCG - where are we now?

Helen McShane

14:18 - 14:33: PL1B-Lessons for TB preventive therapy implementation

Rovina Ruslami

14:33 - 14:48: PL1C-The truth about being TB Proof

Arne von Delft

14:48 - 14:58: PL1D-Moderated discussion

Helen McShane
Rovina Ruslami
Arne von Delft

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SP-08-Incarceration for drug use and TB among people who use drugs: time to break the cycle
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SP-08-Incarceration for drug use and TB among people who use drugs: time to break the cycle
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The interactive panel discussion in this session aims to highlight the impact of over incarceration on the United Nation's High-Level Meeting tuberculosis (TB) targets and the urgent need to reform drug policies as an effective approach in fighting COVID-19, TB and HIV.  It will bring together high-level policy makers, correctional medical doctors, civil society and drug policy makers to identify the influence of the criminalisation of drug use and possession on TB infection rates, to discuss the latest advances in drug policy and to explore how the response to TB can mobilise for drug policy reform.

15:00 - 15:05: Introduction

15:05 - 15:15: Incarceration, drug policies and TB in Tanzania and across Africa: reflections by the community of people who use drugsIn her presentation, Happy will reflect on the impact of incarceration and drug policies on tuberculosis (TB) in Tanzania and across Africa, particularly among women who use drugs. She will also share information about the situation with TB and multidrug-resistant TB, including among the key populations in Tanzania. She will share what concerns her most and what gives her hope for the way forward.
Happy Assan

15:15 - 15:25: The heavy toll of drug policies on TB: prison health and human rightsColleen Daniels will present an overview and discussion on how prisons are a highly ineffective way to deal with people who use drugs. With incarceration rates increasing every year, bad living conditions in prisons, exacerbated by poor access to healthcare, jeopardises the fight against communicable diseases, particularly tuberculosis (TB).  The presentation will discuss how mass incarceration, overcrowded prisons, and human rights violations contribute to fueling TB. These issues are compounded in countries that have high rates of incarceration for drug-related offences and in settings where there is no continuity of treatment for people entering and leaving the prison system. With a global prison population of 11 million people that keeps increasing every year, many prisons in the world are overcrowded due to the incarceration of people for drug-related offences, over 80% of them are in prisons for non violent offences.  In some countries, over 50% of the prison population are held under drug-related offences, while among female inmates this proportion is higher and up to 80% in some countries.  This presentation will outline the need to reform drug policy as an effective approach to fight TB and HIV.
Colleen Daniels

15:25 - 15:35: Reflections and suggestions for the way forward from people who use drugs in AsiaTuberculosis (TB) is one of the fastest growing epidemics among prison populations and one of the main causes of death, particularly in low- and middle-income countries. Yatie Jonet will share cross-Asia perspectives of people, who use drugs, on the influence of criminalisation on health, with a focus on TB. She will share powerful stories about experiences of people who use drugs with incarceration, getting infected in prison and lacking treatment in prison as well as positive stories on access to treatment in prison. She will share suggestions on the way forward from people who use drugs, focusing on the needs of women who use drugs. She will share what concerns her most and what gives her hope for the way forward.
Yatie Jonet

15:35 - 15:45: COVID-19, TB, harm reduction and prisons: challenges and opportunitiesLee will reflect on his personal journey of being the lawyer and the doctor. He will also share information about the situation with tuberculosis (TB) and multidrug-resistant TB, including among the key populations in the Philippines. Prisons and other closed settings are high risk environments for communicable diseases such as HIV, hepatitis C and TB as well as COVID-19. This presentations will draw on experiences in the Philippines. It will discuss that prisons, drug use and HIV are all independent risk factors for the development of TB and amplify each other into synergistic comorbid phenomena.  In the current context, COVID-19 also puts detained people and prison staff at extremely high risk, on top of these existing health threats. Yet the COVID-19 pandemic has also prompted countries to release people who were incarcerated for non-violent offences, including people who use drugs. This approach should urgently be adopted in other countries too and, critically, it opens up a debate about whether people who use drugs have rightly been detained in the first place.
Lee Yarcia

15:45 - 15:55: Vision, evidence and roadmap for the way forwardProfessor Michel Kazatchkine will discuss that punitive approaches to drug use and repressive drug policies have been hindering the results of the investments made in the fight against communicable diseases, particularly tuberculosis (TB). Health outcomes are exacerbated by overcrowding and unhealthy conditions, particularly in Eastern Europe and Central Asia. Michel will discuss how United Nations bodies and other regional human rights monitors could be better at monitoring and reporting on the issue of TB in prisons. Building on data related to incarceration around the world, this presentation will reflect that political will and partnerships - including with the medical, scientific communities, decision makers, parliamentarians and city mayors - are the main driver for drug policy reform and effective response to TB and co-infection. Mobilisation of the community working on addressing TB is key for scale-up of harm reduction services and drug policy reforms. It will discuss that further progressing drug policy reform across countries is key for the effective response to TB The presentation will discuss the impact of over incarceration on the achievement of the UN High-Level Meeting on TB targets, discuss solutions, suggest a way forward as well as reflecting on the presentations made.
Michel Kazatchkine

15:55 - 16:20: Q&A session

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OA-08-The Union student late-breaker session on lung health
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OA-08-The Union student late-breaker session on lung health
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This session is sponsored by the Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association (RIT/JATA).


15:00 - 15:05: Introduction


15:05 - 15:15: LB-2092-21-Utility of previously identified host immunological biomarkers in the diagnosis of TB and monitoring therapy response in high- and low- endemic countries To assess their potential global relevance, candidate tuberculosis (TB) biomarkers require validation in different geographical settings. We evaluated the utility of selected biomarkers in participants recruited from low- and high-TB endemic regions and identified promising biosignatures. Our data highlights the importance of the use of harmonised designs in multicentered studies.

Bih H. Chendi

15:15 - 15:25: LB-1968-21-Characterisation of clinical subtypes of antiretroviral therapy-associated tuberculous meningitis using host transcriptomic analysis Tuberculosis meningitis (TBM) patients are at high risk of IRIS-related (immune reconstitution inflammatory syndrome) mortality, but there is limited data on unmasking IRIS in TBM. We sequenced CSF RNA to describe the host immune response, alongside clinical characteristics, of Ugandan patients presenting with TBM after initiation of antiretrovirals, to determine features of unmasking IRIS.

Carson M Quinn

15:25 - 15:35: LB-2082-21-Assessment of whole genome sequencing technology applied to drug-resistant TB diagnosis In the last decades, whole genome sequencing has become a promising tool in the diagnosis of drug-resistant tuberculosis, evincing the limitations of the phenotypic drug-susceptibility testing. We have evaluated the reliability of its resistance profile prediction in a local study based on a low burden setting of Spain.

Ana María García Marín

15:35 - 15:45: LB-2115-21-Personalised adherence management in TB: using artificial intelligence to schedule targeted interventions We designed an artificial intelligence-based intervention decision support system for community health workers managing tuberculosis medication adherence. The assistant learns to make intervention recommendations, subject to available resources, based on individual patient responsiveness to interventions over time.

Jackson A. Killian

15:45 - 15:55: LB-2119-21-Tale of the tape: use of mid-upper arm circumference to identify increased probability of paediatric TB treatment failure and mortality in a low-resource setting Mid-upper arm circumference (MUAC) independently identifies paediatric tuberculosis (TB) cases that are more likely to later experience TB treatment failure or mortality. Thus, in resource-limited settings, a simple tape measure may aid clinicians in targeting young children in need of more intensive monitoring and clinical care.

Daniel Van Aartsen

15:55 - 16:05: LB-2047-21-Impact of COVID-19 pandemic on latent and active TB treatment registrations in Montreal, Canada: a retrospective study at the Montreal Chest Institute Since the declaration of a global pandemic in March 2020, COVID-19 has disrupted the delivery of tuberculosis (TB) services worldwide. We assessed the effect of COVID-19 on the number of people registered for latent or active TB treatment in Montreal, the city with the highest COVID-19 burden in Canada.

Mariane Saroufim

16:05 - 16:20: Q&A


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OA-07-Moving away from isoniazid for TB preventive treatment
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OA-07-Moving away from isoniazid for TB preventive treatment
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15:00 - 15:05: Introduction


15:05 - 15:13: OA-07-542-21-Safety of high-dose rifamycin for active and latent TB: a systematic review and meta-analysis There is an increasing interest in using rifamycins at higher doses to treat tuberculosis (TB). We performed a systematic review and meta-analysis to examine the safety and efficacy of rifamycin therapy for all patients with TB, by reviewing trials that compared daily administered, high-dose rifamycins to standard-dose rifamycins.

Omri A Arbiv

15:13 - 15:21: OA-07-543-21-Rifampicin maximum, early bactericidal activity not reached at 50 mg/kg The PanACEA HIGHRIF1 trial has recently evaluated the pharmacokinetics (PK) and early bactericidal activity (EBA) of rifampicin at 50 mg/kg. Our analysis focused on defining if earlier developed rifampicin PK and PK-pharmacodynamics models are applicable at a 50 mg/kg dose and if a maximal EBA is reached at 50 mg/kg rifampicin.

Budi O Susanto

15:21 - 15:29: OA-07-544-21-Treatment outcomes of people living with HIV on TB preventive therapy in Lusaka, Zambia Tuberculosis preventive therapy (TPT) has been proven to reduce incidence of TB among people living with HIV (PLHIV). The reduction in TB incidence is more significant in patients who complete a course of TPT compared to those who do not. Improving uptake of TPT among PLHIV is urgently required to reduce the TB burden.

Eugenia Mwamba

15:29 - 15:37: OA-07-545-21-A randomised controlled trial comparing two rifapentine-based short-course regimens for latent TB infection: 1HP vs 3HP 3HP is an attractive regimen for latent tuberculosis infection treatment. However, it is flawed in its systemic drug reactions. By reducing unit drug dosage, 1HP has been shown to have a favourable safety profile in HIV populations. The unanswered questions are the extrapolation of results to non-HIV population and direct comparison with 3HP regimen.

Jann-Yuan Wang

15:37 - 15:45: OA-07-546-21-Preparing for a short-course treatment regimen to prevent TB: catalysing procurement and policy to scale-up 3HP Unitaid funded the IMPAACT4TB project to scale-up 3HP in 12 countries. Work includes updating tuberculosis preventive therapy clinical guidelines, determining the scale of 3HP rollout per country, global 3HP price negotiations, support of generic manufacturers, and discussions with donors and governments to purchase 3HP.

Karin Turner

15:45 - 15:53: OA-07-547-21-Latent TB infection testing and treatment using shortened treatment regimen for contacts and secondary school children in Do Son district, Hai Phong, Viet Nam In 2019, Friends for International TB Relief, together with the Hai Phong TB Programme, implemented a community-wide, mobile screening campaign with integrated tuberculosis (TB) and latent TB infection (LTBI) testing and treatment. We describe the results of the LTBI testing and treatment activities, from screening to treatment completion.

Thuy Thu Thi Dong

15:53 - 16:01: OA-07-548-21-Impact of age on completion rate and systemic drug reaction of rifapentine-based weekly therapy for latent TB infection Under proper medical support and programmatic follow-up, 3HP can be of widespread use among populations of all ages, including the elders. Caution should be given for the high risk of systemic drug reaction in the middle-age population.

Hung-Ling Huang

16:01 - 16:20: Q&A


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TBS1A-Role of innate and adaptive immunity in TB and evaluation of immune correlates in pre-clinical and clinical studies: plenary session
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TBS1A-Role of innate and adaptive immunity in TB and evaluation of immune correlates in pre-clinical and clinical studies: plenary session
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In this session recent insights into the host immune response to M. tuberculosis infection will be discussed. The results from a first tuberculosis (TB) biomarker guided clinical trial will be reported and discussed in the context of TB risk and targeted interventions. The role of innate trained immunity will next be reviewed and discussed, including in the context of BCG vaccination. The emerging role of antibodies in TB will be reviewed as well. The three keynote presentations will be followed by the selected abstract presentations and close with an open panel discussion.


15:00 - 15:03: Introductory note

Tom H. M. Ottenhoff

15:03 - 15:23: TB biomarkers and first results of the CORTIS trial

Thomas Scriba

15:23 - 15:43: BCG vaccination, trained immunity, TB and COVID-19

Reinout van Crevel

15:43 - 16:03: Antibodies as a bridge between the innate and adaptive immune system

Galit Alter

16:03 - 16:22: Live Q&A


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OA-06-Different approaches to improve treatment and care
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OA-06-Different approaches to improve treatment and care
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15:00 - 15:05: Introduction


15:05 - 15:13: OA-06-536-21-Community health workers augment the cascade of TB detection to care in urban slums of two metro cities in India The Tuberculosis Health Action Learning Initiative (THALI) recruited community health workers, in urban slums in two metro cities in India, to augment tuberculosis (TB) detection to care cascade. Their performance and TB treatment outcomes improve over time. It will be important to examine the cost per-TB case detected and successfully treated.

RAJARAM Potty

15:13 - 15:21: OA-06-537-21-Improving isoniazid preventive therapy coverage among children aged 0-14 years living with HIV through designating special clinic days: case of Kapelebyong Health Centre IV Isoniazid preventive therapy demonstrated efficacy of over 60% in preventing active tuberculosis (TB) among people with latent TB infection. However, uptake is low. People of all ages living with HIV, who attend the clinic at the same time, limits opportunities for special care, emphasising the need for age-sensitive HIV clinics to address unique challenges. 

Pius Ongareno

15:21 - 15:29: OA-06-538-21-Using market-based e-pharmacies for delivering free TB drugs to patients treated in the private sector: lessons learned from a pilot in Madhya Pradesh, India This innovative demonstration model of engaging e-pharmacy companies for door step delivery of national TB elimination programme-supplied anti-TB drugs, diagnostic services and treatment adherence support, to patients treated in the private sector.

Varsha Rai

15:29 - 15:37: OA-06-539-21-The potential of mHealth to improve TB awareness and case detection in Tanzania Provide support to the Tanzania National Tuberculosis and Leprosy Program (NTLP)  through the implementation of mHealth technologies to increase case detection and enhance TB knowledge among the general public in Tanzania.

Eunice Moturi

15:37 - 15:45: OA-06-540-21-Identifying subpopulations at high-risk for severe adherence challenges in the treatment of multi- and extensively drug-resistant TB and HIV In generalised epidemics of drug-resistant tuberculosis (DR-TB) and HIV, identifying high-risk subpopulations is critically important to improve treatment outcomes and prevent amplification of resistance. We hypothesised that an electronic dose-monitoring device could empirically identify adherence-challenged patients and that a mixed methods approach would characterise treatment challenges.

Jennifer Zelnick

15:45 - 16:20: Q&A


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Community Connect
Activating a Human Rights Based Tuberculosis Response
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Activating a Human Rights Based Tuberculosis Response
This session takes place on Zoom.us

Panel session: This session will be a follow up to the Human Rights based Response to TB Workshop conducted last year during the Union conference. The session will include presentation and discussion on how to bring a change at the policy level in adopting the HR policy and guidelines at country level. This will be followed by Q and A.

1. Moderator - Blessina Kumar, CEO, Global Coalition of TB Activists
2. Prof. Brian Citro, Assistant Professor, Northwestern Pritzker School of Law
3. Allan Maleche, ED, KELIN
4. Priyam Cherian, Legal Officer, Lawyers Collective
5. Nyokabi Njogu, Advocate, High Court of Kenya
6. Jeffry Acaba, Community representative, APCASO
7. Ani Hernasari, Community representative, POP TB Indonesia
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Channel 1
SS1-Sars-CoV2 - the hope for a vaccine
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SS1-Sars-CoV2 - the hope for a vaccine
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Since the SARS-CoV-2 virus was identified in December 2019, over 37 million people have been infected, and over 1 million deaths have been reported worldwide. Our hopes have been largely focused on the development of a preventative vaccine. But data suggests that immunity may be short lived following infection raises many questions and possible challenges for vaccine development.

15:00 - 15:05: Session introduction


15:05 - 15:20: COVID19 - Public health and scientific challenges

Anthony Fauci

15:20 - 15:30: The COVID19 vaccine portfolio

Vasee Moorthy

15:30 - 15:40: How do we ensure equitable global access to COVID-19 vaccines?

Suerie Moon

15:40 - 15:50: Vaccine hesitancy: until we understand public opinion, we cannot hope to change it

Jeffrey Lazarus

15:50 - 16:00: Going from efficacy trials to public health intervention

Kate O'Brien

16:00 - 16:25: Live Q&A and moderated discussion

Vasee Moorthy
Kate O'Brien
Suerie Moon
Jeffrey Lazarus

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Channel 6
SP-09-Ending TB in vulnerable populations through operational research, capacity building and evidence-informed decision making in Eastern Europe and Central Asia (Find-Treat-All).
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SP-09-Ending TB in vulnerable populations through operational research, capacity building and evidence-informed decision making in Eastern Europe and Central Asia (Find-Treat-All).
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The objective is to present new evidence on optimised case finding, use of digital technology for TB diagnosis and care, and adjunctive interventions in complex cases for key populations in Eastern Europe and Central Asia (EECA). The evidence was generated from EECA researchers under the Structured Operational Research and Training Initiative (SORT IT), which is a global partnership coordinated by the TDR, The Special Programme for Research and Training in Tropical Diseases. The specific SORT IT programme that led to this symposium was implemented by Tuberculosis Research and Prevention Center, Armenia, the Alliance for Public Health, Ukraine, The Union and TDR.

15:00 - 15:05: Introduction

15:05 - 15:15: Breaking the one size fits all paradigm: introduction of optimised case finding of TB among key populations in UkraineMissed tuberculosis (TB) cases are disproportionally concentrated among vulnerable populations that often cannot access health systems. These include socially marginalised individuals (people who inject drugs, displaced, homeless, Roma and former prisoners). Based on experience from an optimised case finding (OCF) strategy, which has been effective in HIV detection among key populations, the Alliance for Public Health in Ukraine has adapted a similar strategy for active TB case finding among vulnerable groups. The OCF strategy empowers index TB cases to refer up to eight close contacts within their social network for TB investigations, in contrast to the usual contact tracing strategy limited to household contacts. Study sites were TB clinics in four regions of Ukraine. Four thousand eight hundred contacts of 600 index TB patients, registered between July 2018 and March 2020, were assessed with respect to numbers of TB contacts referred for investigations, the numbers diagnosed and treated for TB, and the numbers needed to screen.
Liliia Masyuk
Olga Denisiuk

15:15 - 15:25: Scale-up and impact of an electronic medical record system (Open MRS) and GxAlert on diagnosis of TB and linkage to treatment in TajikistanThe advent of the automated Xpert MTB/RIF assay has so far failed to speed up time between diagnosis and treatment of tuberculosis (TB), mainly because of the need for personnel and paper-based interfaces to link results with TB registers. GxAlert is an electronic data monitoring system that automatically connects Xpert instruments to the network and mobile channels to communicate assay results. This should lead to patients being diagnosed and initiated on treatment more quickly. Tajikistan started scaling up GeneXpert instruments in 2014. From 2017 these instruments were connected to GxAlert. During this period, the country scaled-up a new Open MRS medical information system allowing more reliable recording and reporting of TB control efforts. This study presents the scale-up and national coverage of GeneXpert / GxAlert and Open MRS in Tajikistan, between 2014 and 2019, and the impact of this on TB diagnosis and timely linkages between diagnosis and treatment.
Shodmon Khushvakhtov

15:25 - 15:35: Outcomes of video observed TB treatment for drug-susceptible TB in the Republic of MoldovaAsynchronous video observed treatment (aVOT) has been proposed as an alternative method of ensuring medication adherence in tuberculosis (TB) patients, compared with directly observed therapy (DOT). The current study used 2016-2017 secondary data from the randomised clinical trial (RCT) piloted aVOT strategy, in Chisinau, and data from the national TB register. From 647 TB patients included in the study, 169 were from the RCT group (83 – in aVOT and 86 – in DOT) and 478 – DOT in practical conditions (control group). Based on the suggestions of the parent study aVOT may be an acceptable approach to treatment monitoring. Our supplementary results show that aVOT was superior to DOT in terms of treatment outcomes as well; aVOT was associated with short- and long-term TB treatment favourable outcomes. aVOT, as a new patient-centred approach improving treatment adherence and outcomes, might be recommended as an alternative to DOT strategy in the Republic of Moldova.
Svetlana Doltu

15:35 - 15:45: People who inject drugs in Ukraine: comparative analysis of TB treatment outcomes in relation to opioid substitution therapyPeople who use injectable drugs (PWID), who are often socially marginalised and have limited access to health services, are at high risk of being infected with Mycobacterium tuberculosis and developing tuberculosis (TB). Many PWID are also infected with HIV and hepatitis C. Opioid substitution therapy (OST – using methadone or buprenorphine) is one of the pillars of harm reduction strategies for PWID and should be an integral part of TB care. In Ukraine, the Alliance for Public Health coordinates TB and HIV prevention and care services for PWID and has integrated a model of 'OST with TB care at the same facility'. Between July 2017 and July 2019, there were 200 PWID diagnosed with TB in five large regions of Ukraine. The current study documented numbers on OST, socio-demographic and clinical characteristics of those on and off OST and treatment outcomes in relation to OST, HIV status and hepatitis C.
Tetiana Fomenko

15:45 - 15:55: The effect of psychotherapy/psychiatric support for alcohol use disorder for multidrug-resistant TB in Zhytomyr, UkraineUkraine is among the high burden countries for multidrug/rifampicin-resistant tuberculosis (MDR-TB/RR-TB). The country ranks in the top ten for years lost due to disability and premature mortality as a result of alcohol abuse, and TB control efforts are often adversely affected by alcohol use disorder (AUD). Mental health interventions can be effective in reducing alcohol use and together with psychosocial support, these may improve patients’ adherence to TB treatment and result in more favorable TB treatment outcomes. Of 73 patients with RR-TB in Zhytomyr region, Ukraine, 33 were screened positive for AUD and eligible for mental health interventions: 22 received this support and 11 declined. This study compared the two groups with respect to socio-demographic and clinical characteristics, measures of depression, adherence to TB medications and interim/final TB treatment outcomes. The study also assessed why some patients declined to be helped.
Vitalii Plokhykh

15:55 - 16:20: Q&A session

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Channel 4
SP-12-Scale-up of joint action on diabetes and TB: lessons from the field
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SP-12-Scale-up of joint action on diabetes and TB: lessons from the field
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Addressing comorbidities is a core component of patient-centred care within the End TB Strategy. Diabetes is associated with a two to three-fold risk of TB. TB can temporarily cause impaired glucose tolerance and a person with TB is significantly more at risk of dying or relapsing if they also have diabetes - all important reasons for collaborative action as outlined in The Union and World Health Organization 2011 Collaborative Framework for Care and Control of TB and Diabetes. This symposium will present evidence on the global uptake of collaborative action on TB and diabetes and share barriers, enablers, plans and opportunities for scale-up.

16:30 - 16:35: Introduction

16:35 - 16:45: Global status on uptake of the Union/World Health Organization Collaborative Framework for the Management of Tuberculosis and DiabetesThe Union/World Health Organization (WHO) Collaborative Framework for the Management of Tuberculosis and Diabetes was published in 2011. While we have seen impressive scale-up of collaborative action on HIV-associated tuberculosis (TB) globally during this period, uptake and scale-up of collaborative TB and diabetes activities appears to have been limited and difficult to gauge. This presentation will introduce the symposium and provide an overview of findings from a policy review conducted by WHO to assess uptake by high burden TB countries of the collaborative framework for the management of tuberculosis and diabetes and outline plans to promote further scale-up.
Annabel Baddeley

16:45 - 16:55: Addressing comorbidities as part of high impact TB interventions in Global Fund funding requests and grantsThe presentation will share opportunities from the Global Fund to address comorbidity as one of the high impact interventions – this includes the Global Fund strategy and policy on supporting comorbidity, integrated services and promotion of innovations. Further opportunities are available through catalytic funding to support innovative interventions to find missing people with tuberculosis/drug-resistant tuberculosis (TB), including among high risk groups such as people with diabetes. Additional resources to address TB and comorbidity could be leveraged through existing country grants (savings and reprogramming), portfolio optimisation and new grants.
Mohammed Yassin

16:55 - 17:05: Challenges, enablers and plans for scaling up integrated action on TB and diabetes: lessons from PakistanThe dual burden of diabetes and tuberculosis (TB) is a serious and growing challenge for the poorly resourced health system of Pakistan, which ranks 5th among the high TB burden countries. The number of diabetics are estimated to rise to 13.9 million by 2020 in Pakistan, increasing country ranking to 4th in the world. This presentation will give an overview of studies that have been conducted to pilot bi-directional screening for diabetes in TB clinics and for TB in diabetes clinics. It will also discuss the challenges and barriers to integration at all levels of the health system and how the country plans to ensure integrated and structured bi-directional screening, referral, case management and follow-up is scaled up from 2020-2023.
Aurangzaib Quadir Baloch

17:05 - 17:15: Experience of initiating TB preventive treatment among people with diabetes in BrazilThe national tuberculosis (TB) programme of Brazil has recently been introducing a policy on TB prevention among people with diabetes. This presentation will give an overview of the epidemiology of TB and diabetes in Brazil, common aspects and areas for synergy between the two programmes, Brazil’s experience of introducing programmatic management of latent TB infection as well as preliminary results of TB preventive treatment in people affected by diabetes.
Denise Arakaki-Sanchez

17:15 - 17:25: Introducing diabetes into TB-HIV collaboration: opportunities and plans for addressing multimorbidity in ZimbabweZimbabwe is one of the high tuberculosis (TB) burden countries with more than half of people with TB co-infected with HIV. In 2017, the prevalence of diabetes among adults in Zimbabwe is estimated to be 1.8% and over 75.0% of those with diabetes had never been diagnosed. This presentation will give an overview of the epidemiological background and the steps taken to assess feasibility of implementation and to scale-up collaborative action on TB and diabetes in Zimbabwe.  It will further discuss the challenges, enablers, opportunities and plans for national scale-up of integrated TB, diabetes and HIV care.
Charles Sandy

17:25 - 17:50: Q&A session

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Channel 5
SP-13-Deadly partners - COVID-19, non-communicable diseases and tobacco
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SP-13-Deadly partners - COVID-19, non-communicable diseases and tobacco
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There has been a great deal of discussion about the potential relationship between COVID-19 and tobacco use. The underlying logic of a smoking-COVID-19 relationship is that smoking is an established risk factor for respiratory infections because it undermines the immunological response that a person can otherwise mount against a viral infection. Furthermore, there is a very strong relationship between smoking and non-communicable diseases that has emerged as a risk factor for COVID-19 severity and death. Studies from China show that the odds of progression towards serious illness are 14 times higher among people with a history of smoking.

16:30 - 16:35: Introduction

16:35 - 16:47: COVID-19, non-communicable diseases and impact on young peopleYoung people, especially those living with non-communicable diseases (NCDs) and its associated risk factors are vulnerable and susceptible to developing COVID-19 and its complications. This includes incomplete treatment regimens and restricted access to public health services for chronic conditions in times of lockdown and social distancing. Not to forget the major impact on mental health of young people. On the other hand, young people are also critical in promoting preventive messages for risk mitigation, disseminating information to their families, peer groups and community during this global crisis. Therefore, meaningful involvement of young people during the time of pandemic, as well as prevention of NCDs, is significant to the preparedness efforts, for not only the current, but also future public health crises.
Ishu Kataria

16:47 - 16:59: COVID-19 and lung healthCurrently evidence is lacking on how underlying lung disease will affect the severity and outcomes of COVID-19.  The longer term impact of COVID-19 on lung health is unknown but with large numbers of people requiring high flow oxygen and/or ventilation there are concerns regarding residual lung damage in COVID-19 survivors. The data on these areas will be reviewed as well as discussing what services need to be planned for COVID-19 survivors.
Grania Brigden

16:59 - 17:11: Deadly partners: COVID-19 and tobaccoTobacco smoking appears to be an important and entirely avoidable risk factor for a poorer prognosis in COVID-19. COVID-19 has not only severely constrained health systems, but also could have a cascading impact on the progress that countries were making towards different goals and targets of the United Nations Sustainable Development Goals (SDGs). With the looming danger of economic recession, it becomes even more vital to avert the huge financial cost of tobacco use to the global economy. The urgency to prioritise stronger action on comprehensive tobacco control is mandatory for optimal response to contain the COVID-19 pandemic.
Tara Singh Bam

17:11 - 17:23: Responding COVID-19 and non-communicable disease risk factorsTobacco causes eight million deaths every year and is a known risk factor for severe disease and death from many respiratory infections. Emerging evidence has suggested that smoking increases the risk of severe COVID-19 outcomes as well as the risk of death from COVID-19. However, in the absence of robust population studies to date, the association between smoking and infection with SARS CoV2 and between smoking and hospitalisation has not been reliably quantified.  This presentation will review the evidence on smoking and COVID-19 and will position the findings within the context of the wider literature and body of evidence. It will also look at risk communication of the findings on tobacco use and COVID-19 in the overall context of harms from tobacco use that are well established.
Hebe Gouda

17:23 - 17:50: Q&A session

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Channel 1
OA-09-What person-centred care really means
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OA-09-What person-centred care really means
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16:30 - 16:35: Introduction


16:35 - 16:43: OA-09-550-21-Using the patient pathway analysis method to align care-seeking and service delivery in development of a person-centred, national strategic plan The patient pathway analysis uses data to identify a mismatch between tuberculosis (TB) healthcare-seeking and service delivery. Fifty eight percent of the population initially sought care in private facilities, of which only 2% were equipped with diagnostic capacity for TB, emphasising the need to engage private sector facilities in TB control.

Moses Arinaitwe

16:43 - 16:51: OA-09-551-21-A 360 degree view of TB-related stigma in Uganda: findings from a mixed methods study involving perceptions from patients, providers and communities Stigma is a key driver that hinders tuberculosis (TB) control programmes by negatively affecting delay in care-seeking and treatment adherence. A mixed methods assessment was conducted to understand perceptions and knowledge of TB-related stigma among TB providers, patients and community members, to inform  TB programme strengthening efforts in Uganda.

Nikki Davis

16:51 - 16:59: OA-09-552-21-Support for integrating TB preventive treatment into community antiretroviral refill groups among people on antiretroviral treatment in Zimbabwe Zimbabwe's 2018 tuberculosis (TB) incidence - 210/100,000 - is among the highest globally. However, only 11% of people living with HIV (PLHIV) and newly enrolled in care, were on TB preventive treatment (TPT) in 2017. Community antiretroviral refill groups can be an efficient way to scale-up TPT in PLHIV in Zimbabwe. 

Jennifer M. Zech

16:59 - 17:07: OA-09-553-21-Integrating mental health services into TB care: Gujarat, India Mental health interventions to treat depression among tuberculosis (TB) patients were integrated into routine TB workflows. Healthcare workers, trained in psychotherapeutic counselling, screened for depression symptoms, administered 4-6 sessions with patients and measured reduction in depression symptoms with each session.

Sirisha Papineni

17:07 - 17:15: OA-09-554-21-Journey patterns and models of care observed in patients receiving drug-resistant TB treatment in South Africa This analysis uses spatio-temporal mapping of patient care journeys in South Africa to describe diverse patterns - ranging from highly centralised to highly decentralised - and uses these to provide structure to illustrate existing models of care. Five dominant geospatial movement patterns of patient journeys, and the associated care models, are described. 

Lindy Dickson-Hall

17:15 - 17:23: OA-09-555-21-Implementation of a supportive care package to strengthen drug-resistant TB patients' adherence to treatment in Xi'an, China Implementation of a comprehensive, supportive care package to strengthen treatment enrollment, retention and treatment adherence to among drug-resistant tuberculosis patients managed by Xi’an City Chest Hospital, western China

Ali Zhao

17:23 - 17:50: Q&A


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Channel 7
TBS1B-Role of innate and adaptive immunity in TB and evaluation of immune correlates in pre-clinical and clinical studies: oral abstract presentations
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TBS1B-Role of innate and adaptive immunity in TB and evaluation of immune correlates in pre-clinical and clinical studies: oral abstract presentations
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In this session recent insights into the host immune response to M. tuberculosis infection will be discussed. The results from a first tuberculosis (TB) biomarker guided clinical trial will be reported and discussed in the context of TB risk and targeted interventions. The role of innate trained immunity will next be reviewed and discussed, including in the context of BCG vaccination. The emerging role of antibodies in TB will be reviewed as well. The three keynote presentations will be followed by the selected abstract presentations and close with an open panel discussion.

16:30 - 16:32: Session introduction


16:32 - 16:40: TBS-OA-01-Inflammatory markers in the cerebrospinal fluid linked to mortality in tuberculous meningitis

Valerie A.C.M. Koeken

16:40 - 16:48: TBS-OA-02-Vaccination with intravenous BCG protects SIV+ macaques from tuberculosis.

Erica Larson

16:48 - 16:56: TBS-OA-03-A pilot study on plasma metabolomic characterization of patents with MDR-TB

Qi Tan

16:56 - 17:04: TBS-OA-04-A 22-gene transcriptomic model predicting individual therapy durations in multidrug-resistant tuberculosis

Jan Heyckendorf

17:04 - 17:12: Live Q&A


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Channel 2
SP-10-High-dose rifapentine with or without moxifloxacin for shortening treatment of TB: TB Trials Consortium study 31/ACTG A5349 phase III clinical trial results
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SP-10-High-dose rifapentine with or without moxifloxacin for shortening treatment of TB: TB Trials Consortium study 31/ACTG A5349 phase III clinical trial results
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Study 31/A5349 is a phase III randomised controlled non-inferiority trial to evaluate the efficacy and safety of two, four-month regimens with high-dose rifapentine with or without moxifloxacin for the treatment of drug-sensitive tuberculosis (TB). The trial is a collaboration between the TB Trials Consortium (TBTC) and the Adult AIDS Clinical Trials Group (ACTG).  In this symposium, we will present the trial design and results of the primary 12-month analysis. In addition, presentations will discuss safety of the short regimens, selected secondary and sensitivity analyses, local medical and community perspectives, plus lessons learned and next steps.

16:30 - 16:35: Introduction

16:35 - 16:45: The design and primary efficacy results of Study 31/A5349In this talk the design and the efficacy results for Study 31/A5349, a randomised, open-label, controlled phase 3 trial, will be presented. The trial’s primary efficacy endpoint is tuberculosis (TB) disease-free survival at 12 months after study treatment assignment. A total of 2,516 participants, from 33 sites in 13 countries, were enrolled. The proportion of participants, who are culture-negative at eight weeks, and time to stable sputum culture conversion (on solid and liquid media) will also be reported.
Susan Dorman

16:45 - 16:55: Safety of high-dose rifapentine regimensThis talk will review safety data of the two high-dose rifapentine regimens. The proportion of participants with grade 3 or higher adverse events during study drug treatment will be described. Rates of discontinuation of assigned treatment for a reason other than microbiological ineligibility, will be reported. All-cause mortality, including all deaths from any cause during treatment or follow-up up, will be described with primary cause of death reported by the regimen. The presentation will also include suggestions for safety monitoring and patient management for the short regimen in programmatic settings.
Ekaterina Kurbatova

16:55 - 17:05: Secondary efficacy and safety analyses of short regimen performance by disease phenotypes and patient subgroupsKnown risk factors for relapse and treatment failure include extensive cavitation, higher smear grade, low BMI and a compromised immune system because of HIV infection or uncontrolled diabetes. This talk will review results of secondary analyses that further explore the efficacy and safety of the short regimens, highlighting particular groups of patients that experienced the most benefit.
Payam Nahid

17:05 - 17:15: Perspectives on shortened TB regimens: local medical and community viewsThis talk will focus on local medical and community perspectives considering the promise, value-add and possible challenges and solutions to implementation of short tuberculosis regimens. These will be considered in a specific country setting, contextualising the findings.
Grace Muzanye

17:15 - 17:25: Lessons learned and next stepsThis talk will discuss lessons about inclusion of adolescents and HIV-positive individuals with CD4 count threshold of 100 cell/mm3, adherence, regional differences, a novel 'possible poor treatment response' process for endpoint ascertainment, and the value of standardised laboratory techniques. Relevant future actions will be considered.
Richard Chaisson

17:25 - 17:50: Q&A session

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SP-14-Is TB elimination in the European Region a realistic goal?
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SP-14-Is TB elimination in the European Region a realistic goal?
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The World Health Organization, in collaboration with the European Respiratory Society, formulated a framework towards the elimination of TB in 33 counties with currently low TB incidence, to be achieved by 2050. The symposium provides the stage for a pro/con discussion on the feasibility of this framework. It addresses the current state of affairs around some of the key priorities stated in the framework as being instrumental to reach TB elimination in low-incidence counties. These include the care for vulnerable groups, dealing with cross-border health seeking and investments in research and new tools for diagnosis and prevention.

16:30 - 16:35: Introduction

16:35 - 16:45: Mission possible: TB elimination in EuropeThe European Union (EU) and European Economic Area (EEA) observes a decline in tuberculosis (TB) notification rate of about 5% per year. This is not enough to reach TB elimination or a reduction of the TB incidence rate of 80% by 2030 (SDG target).  The too slow decrease of TB incidence is partly due to the increasing percentage of TB cases in migrants; in many EU/EEA countries with a low TB notification rate, >75% of TB cases are among migrants. Cases in migrants need to be diagnosed and treated but may be hard to prevent if infection occurred outside of the EU/EEA. Therefore, elimination can be better defined as no local transmission as measured by whole genome sequencing. By using whole genome sequencing data (EU/EEA wide and from selected countries) the potential for TB elimination will be presented and challenges identified.
Marieke van der Werf

16:45 - 16:55: Mission impossible: TB elimination in EuropeProjecting the incidence data of tuberculosis (TB) from the past decade into the future, suggests that elimination of TB in the European Union/European Economic Area (EU/EEA) might be achieved by 2035. However, in a globalised world, elimination of TB in the EU/EEA appears unlikely and even if this unlikely scenario were to happen, the elimination of TB in Europe would still be far out of reach. Only a small fraction of patients with TB in Europe live in the EU/EEA. Some countries in central and eastern Europe still have a high incidence of TB and central/eastern Europe is one of the hotspots of multidrug-resistant/rifampicin-resistant TB globally. The obstacles on the way to elimination are in all areas: prevention, diagnosis and treatment. Without a vaccine that protects contacts of patients with TB from the development of TB, elimination of TB will not be achieved, neither in Europe nor anywhere else.
Christoph Lange

16:55 - 17:05: Translational research and new tools in the pipeline to eliminate TB in low burden countriesTuberculosis (TB) elimination in low burden countries requires a comprehensive effort with existing and new tools. This presentation will familiarise the audience on recent diagnostic innovations in the pipeline to improve active case finding, infection detection and prediction of risk.
Morten Ruhwald

17:05 - 17:15: Access to care for vulnerable populations in EuropeTuberculosis (TB) burden in Europe is particularly high among vulnerable population groups. These groups also have an increased risk of inadequate access to diagnosis and treatment results. This is why access to healthcare for vulnerable groups, including migrants, is both important for individual care of patients and to ensure a reduction of transmission that would be necessary for TB elimination in Europe. Here, we will discuss 1) current evidence on access of care for vulnerable population groups in Europe; 2) evidence on strategies and policies effective at increasing access to care and lowering transmission of TB, and 3) some considerations on ethics, equity and legal issues in the design of these policies
Berit Lange

17:15 - 17:25: Research collaborations informing TB control strategies in Europe: TBnet and ERS-CRC approachTBnet has performed a large number of clinical and operational studies in the field of tuberculosis (TB). The consortium is supported by the European Respiratory Society, through a clinical research collaboration. The activities provided insight in - amongst others - the unequal distributions across Europe in terms of infection control facilities, the staff available, and inpatient vs. outpatient management of TB, the inclusion of 'hard to reach' groups, the cost and availability of molecular diagnostic tests for multidrug-resistant TB, the availability, cost and stability of drug supply, the adverse effects of new drugs, and the confounding effect of relapse on treatment outcomes.  
Graham Bothamley

17:25 - 17:50: Q&A session

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SP-11-Treating mild asthma: a paradigm shift
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SP-11-Treating mild asthma: a paradigm shift
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Management of mild asthma has for a long time been unsatisfactory and the treatment of mild asthma has not been tested in clinical trials. The use/overuse of short-acting beta-2 agonist (SABA) alone in patients treated as mild asthmatics has become a concern and the association with severe adverse events has become clear. Access adherence with regular inhaled corticosteroid (ICS) treatment is a major issue in this population. The rationale efficacy of treatment with as needed ICS and rapid acting bronchodilator will be discussed in this session.

Learning Objectives:

Review concerns associated with the use of rescue SABA in the absence of maintenance treatment.

Discuss the merits of as-needed ICS treatment strategies in mild asthma in adults and children.

16:30 - 16:35: Introduction

16:35 - 16:47: GINA 2019: a fundamental change in asthma managementNew recommendations about the treatment of mild asthma, published by the Global Initiative for Asthma (GINA) in early 2019, have been described as the most fundamental change in asthma management in 30 years. These recommendations represented the culmination of a decade-long campaign by GINA to develop new strategies for mild asthma with the aim of reducing asthma morbidity and mortality, particularly in low-resource countries. They were prompted by concerns about the risks and consequences of treating mild asthma with short-acting beta2-agonists alone. This presentation will describe the background to the changes, the evidence obtained from large, new clinical trials and observational studies which provided the basis for the new GINA recommendations, the issues and priorities that were taken into account, and the global challenges and evidence gaps that remain.
Helen Reddel

16:47 - 16:59: As-needed use of ICS and SABA in separate inhalers? Applicability to childrenOne of the more frequent issues in difficult asthma in children is adherence. Using inhalers only when they are needed could be a good way to improve adherence and control. This presentation would update the evidence on the efficacy of treating asthma in children using as needed combination of short-acting beta-2 agonists and corticosteroids combined in the same inhaler, as compared to the standard approach in GINA guidelines. If this is approach is safe and effective in children, as well as being more affordable, it should be seriously considered.

Luis Garcia-Marcos

16:59 - 17:11: Combination inhaler (ICS/ formoterol) applicability to children: a low- resource setting perspective.Asthma in children is increasing in prevalence in children in low- and middle-income countries. Risk factors for this increase and poor asthma control in this population are poorly studied. One of the critical gaps in asthma treatment is access to affordable and safe medication delivered via an appropriate delivery system. The current Global Initiative for Asthma recommendations encourage the use of combination therapy to improve asthma control, but this may not be possible in settings where there is poor access to spacer delivery systems and unaffordability of drugs. Motivation for one drug device to manage asthma is an attractive option in this setting where there is an overuse of short-acting beta-agonist, together with interventions and advocacy, to improve access to asthma treatment and this may be a solution to this issue in low-income settings.
Refiloe Masekela

17:11 - 17:23: Obtaining optimal control of asthma in resource-limited settings: theory and practiceThe management of asthma requires medicines relaxing airway smooth muscles and reducing airway inflammation. Rapid-acting b2 agonist does not effectively address the underlying problem of airway inflammation. Excess use of inhaled bronchodilators alone for symptom relief may result in a delay in seeking health care. Inhaled corticosteroid (ICS) is critical in the treatment of airway inflammation but is underused. A substantial proportion of patients with persistent asthma in resource-limited settings have no access to affordable ICS for long-term treatment. Studies have shown that the use of both ICS and rapid-acting b-agonist as needed for symptom relief might be a better option.
Chen-Yuan Chiang

17:23 - 17:50: Q&A session

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Channel 7
TBS1C-Correlates of risk versus protection: panel discussion
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TBS1C-Correlates of risk versus protection: panel discussion
*Please scroll down for more information*
In this session recent insights into the host immune response to M. tuberculosis infection will be discussed. The results from a first tuberculosis (TB) biomarker guided clinical trial will be reported and discussed in the context of TB risk and targeted interventions. The role of innate trained immunity will next be reviewed and discussed, including in the context of BCG vaccination. The emerging role of antibodies in TB will be reviewed as well. The three keynote presentations will be followed by the selected abstract presentations and close with an open panel discussion.


17:20 - 17:45: Panel discussion

Thomas Scriba
Reinout van Crevel
Galit Alter
Ann Ginsberg

17:45 - 18:05: Live Q&A

Thomas Scriba
Reinout van Crevel
Galit Alter
Ann Ginsberg

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Channel 3
SS5-History of The Union
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SS5-History of The Union
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Session Organised by: German Central Committee against Tuberculosis (DZK)

„History of The Union”
The centennial of The Union is a good opportunity to look back on some aspects of its long history. Since it is not possible in the allotted time to recognize all other important organizations worldwide, which are linked to The Union including their African, Asian-Pacific and South American Regions, the session has to concentrate on a few others. It is moderated by Dean Schraufnagel, former member of the Board of Directors of The Union and Past President of the ATS.
Since the Centennial of The Union coincides with the 125th anniversary of the German Central Committee against Tuberculosis (DZK), this year's Robert Koch Lecture provides a good opportunity for Robert Loddenkemper, Past President of DZK, of the Europe Region of The Union and of the ERS, to underline the close relationship of the DZK with The Union. The Robert Koch Lecture was initiated by Rudolf Ferlinz, Secretary General of DZK and President of the Union, at the 1994 World Conference in Mainz/Germany. Since 1994 six Robert Koch Lectures have been given by prominent TB experts at The Union World Conferences.
The roots of the Union are going back to the International TB Congress in Berlin 1902, where an "International Central Bureau for the Fight against Tuberculosis" was established, which can be seen as predecessor of The Union. It had the headquarters in Berlin, and Gotthold Pannwitz, Secretary General of DZK, took over the management of the bureau and of the international monthly journal "Tuberculosis". In 1895, Pannwitz was also the main initiator of the foundation of the “German Central Committee for the Establishment of Sanatoria”, one of the oldest national TB organizations worldwide. In 1905 the name of the Committee was changed to “…for the Fight against Tuberculosis". Out of this reason Robert Koch, being critical of the sanatorium movement, finally accepted to join the Committee.
Periodic international conferences systematically addressing clinical, research, and sociological aspects of TB were held until the outbreak of World War I in 1914. After the war, in 1920, a conference on TB was convened in Paris, at which the International Union Against Tuberculosis (IUAT) was founded. Until 1939, ten international conferences followed, the 11th Conference was planned to take place in Berlin in September 1939, but had to be cancelled because WW II was started by Germany on 1ST September. When the Nazis came into power in January 1933, a very dark chapter in TB control started under the general health-related motto “Public interest comes ahead of self-interest”. The horrible consequences for TB patients are described in detail. In June 1940, after the occupation of Paris, the Nazis closed the IUAT Office, which was reopened again after the war, in 1946.
During World War II, TB mortality had increased steeply in many belligerent and non-belligerent countries. This induced a broad international cooperation. Mario Raviglione, year-long former Director of the Global TB Programme at the WHO, describes in the second lecture, how the WHO was officially established by the UN in 1948, when malaria, TB, and venereal diseases were declared as the “3 main scourges demanding prior and special attention”. Just from the beginning, the Executive Committee established for TB a close relationship with the IUAT, the beginning of a very fruitful cooperation. In the mid-1960s, the Tuberculosis Surveillance Research Unit (TSRU) with The Union and the WHO as important members was initiated by KNCV. The results of the annual meetings were published in several guidelines/reports on Drug Resistance, which are now incorporated into the annual Global TB Reports of the WHO.  With the advent of HIV in the mid-1990s, the collaboration was intensified. The concept on DOTS, developed by Karel Styblo, Executive Director of The Union, was promoted by the WHO as a new strategy for TB control. There were many other fields of close cooperation, amongst them the World TB Day initiated in 1982 by The Union and later recognized officially as an annual event by the WHO.
Philip Hopewell, former President of the North American Region of The Union and of the ATS, describes in the third lecture the long and close relationship of the North American organizations from Canada und USA with The Union. The North American Region of The Union was founded in 1990. North American organizations with “informal” but influential relationships with The Union are United States Agency for International Development (USAID), the US Centers for Disease Control and Prevention (CDC), many academic institutions in US and Canada and NGOs (FHI 360, MSH, PATH). Lobbying effort for funding of global TB control were initiated by ALA/ATS in 1992. ALA/ATS convened advisory groups including the Union and the Tuberculosis Coalition for Technical Assistance (TBCTA), which was founded in 2000 at the request of USAID and original partners (The Union, WHO, CDC, KNCV, ALA/ATS). Between 2000-2019 USAID alone funded more than 900 Million USD for TB control.
In the last lecture, Giovanni Battista Migliori, Past President of the Europe Region of The Union, former ERS Secretary General and at present Chair of the Global TB Network and one of the two Chief Editors of the IJTLD, describes mainly the many activities in Europe during the last thirty years. The Europe Region of The Union was founded only in 2002 with the particular aim to increase the collaboration between Western and Eastern Europe, the latter with its high TB incidences and frequent drug resistances (MDR-TB). European organizations, which had been active already before, are WHO-Europe, KNCV, The Union and the ERS. All supported the two-yearly conferences of the Europe Region in Budapest, Bucharest, Moscow, Riga, Dubrovnik, London and Bratislava. KNCV organizes since 1990 the Wolfheze Workshops, at which experts from low incidence countries developed basic TB principles and documents allowing Europe to equip itself with surveillance, policies and guidelines for TB control and elimination. In other initiatives the Europe Region collaborates closely with ERS, WHO-Europe, ECDC, EU and many national respiratory societies, also on topics like prevention of smoking and non-communicable diseases.

18:15 - 18:19: Introduction


18:19 - 18:42: Robert Koch lecture: the history of the German Central Committee against Tuberculosis and its close relationship with The Union

Robert Loddenkemper

18:42 - 19:01: The World Health Organization and its close relationship with The Union

Mario Raviglione

19:01 - 19:20: North American organisations and their close relationship with The Union

Philip Hopewell

19:20 - 19:39: European organisations and their close relationship with The Union

Giovanni Battista Migliori

19:39 - 19:43: Closing remarks


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Channel 4
MTE-03-Meet the expert session: Nurses & Allied Professionals
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MTE-03-Meet the expert session: Nurses & Allied Professionals
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Using existing and emerging digital technology to enhance virtual, remote and supportive patient care and management during and beyond COVID-19

Please note that the number of participants is limited to 50 for this session.

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Channel 1
SS-01-TB diagnostic network assessment: innovative and comprehensive TB diagnostic network assessment model
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SS-01-TB diagnostic network assessment: innovative and comprehensive TB diagnostic network assessment model
*Please scroll down for more information*
Organised by: The United States Agency for International Development / Infectious Disease Detection and Surveillance (IDDS) project

The tuberculosis (TB) diagnostic network assessment is an innovative, holistic and comprehensive way to assess a country's dedicated TB diagnostic network. It's a country driven activity which involves local and external TB experts. This joint activity assesses the functionality of a country's TB diagnostic, in line with the national strategic plan and the End TB strategy. This assessment and review will help the country to identify key gaps and recommendations as well as help to strengthen a comprehensive TB diagnostic network with strong underlying health systems. 

Target audience 1: Doctors, Nurses, Lab technicians
Target audience 2: Clinicians, TB programme managers, activists
Target audience 3: TB project managers, NGOs



18:15 - 18:20: Introduction


18:20 - 18:35: Improving TB diagnostic access by the TB diagnostic network assessment model The Tuberculosis (TB ) diagnostic network assessment (DNA) is a country driven process that assesses the functionality of the national TB diagnostic network and system. It helps in determining the system’s capacity to meet the needs of the country’s national TB strategic plan (NSP) for achieving the goals outlined in the End TB strategy. The TB DNA reviews, holistically, the diagnostic network and current practices and algorithms; identifies challenges that prevent the diagnostic network from performing efficiently and effectively and proposes evidence-based interventions to improve the overall ability of the diagnostic network to meet the goals and targets of the NSP.

Amy Piatek

18:35 - 18:50: The TB diagnostic network assessment tool presentation The use of an assessment tool, with semi-quantitative scoring, for the country to identify the stage of various aspects of the diagnostic network and to describe current capabilities and identify key areas for improvement. Verification of the self-assessed staging, using a set of standardised tools and checklists, and including site visits to a selection of sites. Conducted by an experienced group of international laboratory experts with support from in-country lab and TB experts.

Thomas Shinnick

18:50 - 19:05: TB diagnostic network assessment: data and spatial analysis The spatial TB diagnostic network analysis will be used to inform tuberculosis diagnostic network assessment (TB DNA) planning on a selection of regions to be assessed during the in-country visit  - brief the TB DNA teams about TB diagnostic network situation (coverage, access and effectiveness) prior to/at the beginning of the assessment visit; inform conclusions and support the development of recommendations by the TB DNA team during the assessment visit; develop baseline network scenarios, which can be refined during the TB DNA in-country visit, based on findings and assumptions for additional diagnostic instruments, relocated instruments, altered specimen referral linkages or other.

Manuela Rehr

19:05 - 19:20: Infectious Disease Detection and Surveillance project support to countries on the TB diagnostic network assessment The Infectious Disease Detection and Surveillance (IDDS) project is currently working closely with countries’ national tuberculosis (TB) control programmes to reinforce TB and drug-resistant TB diagnostics for all eligible patients. The TB diagnostic network assessment (TB DNA) has already been conducted in India, Uganda and Zimbabwe. The upcoming countries for 2020 are Tanzania, Viet Nam and Bangladesh. We are also working with relevant stakeholders to conduct this assessment in Mozambique and Burma. The support from IDDS is based on the respect of human rights and that access to all these diagnostic technologies should be available, regardless of a population’s income or cultural, racial, gender, religious or ethnic inclination.

Inoussa Zabsonre

19:20 - 19:45: Q&A session


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Channel 2
SS-02-Shining a new light on TB diagnostics
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SS-02-Shining a new light on TB diagnostics
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Organised by: Cepheid

The overall objective of the session will support the audience to gain deeper insights on latest innovations in TB diagnostics. 
The panelists will walk through novel technologies to improve drug-susceptibility testing, host response concepts as well as clinical insights to leverage available diagnostic tools.
* CE-IVD. In Vitro Diagnostic Medical Device. Product not available in the United States.

18:15 - 18:25: Introduction


18:25 - 18:45: Behind the scenes – Innovations in TB diagnostics Dr. Gnanashanmugam will share insights about the innovation behind the Xpert® MTB/XDR assay* and Cepheid’s technology.

Devasena Gnanashanmugam

18:45 - 19:05: Evaluation of Xpert® MTB/XDR* and possibilities of integration into the National diagnostic algorithm – the South African perspective Dr. Omar will present the first clinical evaluation of the recently launched Xpert® MTB/XDR* assay in South Africa.
* CE-IVD. In Vitro Diagnostic Medical Device. Product not available in the United States.

Shaheed Vally Omar

19:05 - 19:25: Demonstrating the power of heterogeneity: from discovery to point-of-care using public data for tuberculosis diagnosis Dr. Khatri will speak about host response gene signatures in Tuberculosis and share further insights.

Purvesh Khatri

19:25 - 19:45: Using available TB diagnostics to Guide Patient Management – A Clinical Perspective Prof. Kon will share his experience as a clinical expert in how to leverage diagnostic tools for patient management.  
 

Onn Min Kon

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Community Connect
CommunityFirst COVID-19 Roadmap
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CommunityFirst COVID-19 Roadmap
This session takes place on Zoom.us

SeeChange works in close partnership with local communities and their organizations, such as Ilisaqsivik in Clyde River, Nunavut (ilisaqsivik.ca). 'Flattening the curve' of the COVID-19 pandemic in a particular setting requires the community to be front and centre in the development and implementation of essential activities. SeeChange and Ilisaqsivik have developed a practical tool called the 'CommunityFirst COVID-19 Roadmap' to assist communities in their planning and response to the threat of COVID-19 (www.communityfirstcovid19.org). This Roadmap offers a step-by-step guide for communities to create a plan to Organize, Prepare, Respond, and (just as importantly) Recover from COVID-19. During this webinar, utilization of the Roadmap tool will be described in detail by the Community Readiness Coordinator at SeeChange, with support from the Medical Director.

Jessica Farber, Community Readiness Coordinator, SeeChange Initiative 
Peter Saranchuk, Medical Director, SeeChange Initiative
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Channel 5
CANCELLED - MTE-04-Meet the expert session: TB
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CANCELLED - MTE-04-Meet the expert session: TB
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BCG protection against COVID-19

Please note that the number of participants is limited to 50 for this session.

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Channel 3
SS-05-Leave no one behind: we can defeat COVID-19 and latent TB infection together
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SS-05-Leave no one behind: we can defeat COVID-19 and latent TB infection together
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Organised by: QIAGEN
Global health experts are working to slow the COVID-19 pandemic – but responding to COVID-19 has also forced disruption of existing TB control programs around the globe. QIAGEN is committed to fighting COVID-19 and TB, developing innovative new testing solutions so that no one is left behind in the battle against pandemic lung diseases. Join our interactive symposium as we discuss QIAGEN's evolving solutions in two parts:
Part 1. QIAreach QuantiFERON-TB: A simple and accurate solution for decentralized TB infection screening
Currently in development, the QIAreach QuantiFERON-TB is a field-friendly, portable latent TB testing solution that will expand access to TB testing where it's needed the most. QIAGEN's assay development team will introduce the test and provide a scientific review of early performance data. This will be followed by first-hand experiences from ongoing trials of the test conducted in Zambia.

Part 2. Tackling TB and COVID-19 together: From centralized to decentralized testing
Stop TB and the WHO have highlighted the overlapping symptoms and risk groups shared by COVID-19 and TB. QIAGEN's Dr. Masae Kawamura will discuss shared disease etymologies and introduce QIAGEN's portfolio of cutting-edge solutions for both centralized and decentralized testing. Centralized solutions include: QuantiFERON-TB Gold Plus (TB) and QIAstat-Dx Respiratory SARS-CoV-2 Panel (SARS-CoV-2). Decentralized solutions include: QIAreach QuantiFERON-TB (TB), QIAreach Anti-SARS-CoV-2 Total (not available in all markets) and QIAreach SARS-CoV-2 Antigen Test (SARS-CoV-2).
Products and product claims may differ from country to country based on regulations and approvals. Contact your country representative for further details.
QIAreach QuantiFERON-TB and QIAreach SARS-CoV-2 Antigen are currently under development and coming soon. QIAreach QuantiFERON-TB is intended for high-TB-burden countries.

09:45 - 09:50: Introduction


09:50 - 09:57: QIAreach QuantiFERON-TB: a simple and accurate solution for decentralised TB infection screening Currently in development, the QIAreach QuantiFERON-TB is a field-friendly, portable latent tuberculosis (TB) testing solution that will expand access to TB testing where it's needed the most. QIAGEN's assay development team will introduce the test and provide a scientific review of early performance data. This will be followed by first-hand experiences from ongoing trials of the test conducted in Zambia.

Kwame Shanaube

09:57 - 10:11: Tackling TB and COVID-19 together: from centralised to decentralised testing Stop TB and the World Health Organization have highlighted the overlapping symptoms and risk groups shared by COVID-19 and tuberculosis (TB). QIAGEN's Dr. Masae Kawamura will discuss shared disease etymologies and introduce QIAGEN's portfolio of cutting-edge solutions for both centralised and decentralised testing. Centralised solutions include: QuantiFERON-TB Gold Plus (TB) and QIAstat-Dx Respiratory SARS-CoV-2 Panel (SARS-CoV-2). Decentralised solutions include: QIAreach QuantiFERON-TB (TB), QIAreach Anti-SARS-CoV-2 Total (not available in all markets) and QIAreach SARS-CoV-2 Antigen Test (SARS-CoV-2).

Masae Kawamura

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Channel 2
SS-04-Innovative Medicines Initiative Antimicrobial Resistance Accelerator: a new public-private partnership to tackle antimicrobial resistance
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SS-04-Innovative Medicines Initiative Antimicrobial Resistance Accelerator: a new public-private partnership to tackle antimicrobial resistance
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Organised by: Uppsala University and Carlos III University
The Innovative Medicines Initiative (IMI) Antimicrobial Resistance (AMR) Accelerator is a recently formed consortium of over 50 partners, unified by a common goal of developing new tools and therapeutics to fight resistant pathogens, with a particular focus on targeting tuberculosis (TB) and Gram-negative bacteria.   The initiative is comprised of three core pillars: COMBINE, a capability building network; ERA4TB, a TB drug development  network; and portfolio building networks that include the projects TRIC-TB and RespiriTB. The scope of the AMR Accelerator is broad;  aiming to consolidate expertise under one structure to tackle AMR and accelerate the progression of antibiotics towards the clinic.

09:45 - 09:55: Innovative Medicines Initiative Antimicrobial Resistance Accelerator: structure and strategy Presentation of the consortium supporting all the projects in the Antimicrobial Resistance Accelerator: COMBINE

Karen O´Dwyer

09:55 - 10:10: The European Regimen Accelerator for Tuberculosis (ERA4TB): concept, vision and progress Presentation of the consortium looking at progressing antitubercular drugs within the Antimicrobial Resistance Accelerator: ERA4TB

Stewart Cole

10:10 - 10:20: Innovative Medicines Initiative Antimicrobial Resistance Accelerator: a new public-private partnership to tackle the antimicrobial resistance issue worldwide: Tric TB Presentation of Tric TB: portfolio building networks of the Antimicrobial Resistance Accelerator.

Michel Pieren

10:20 - 10:30: New approaches to targeting the respiratory chain of M. tuberculosis Presentation of RespiriTB: portfolio building network of the Antimicrobial Resistance Accelerator.

Meindert Lamers

10:30 - 10:45: Q&A session


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Channel 1
SS-03-Approaches to improve TB case finding and treatment outcomes in children
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SS-03-Approaches to improve TB case finding and treatment outcomes in children
*Please scroll down for more information*
Organised by: Johnson & Johnson Global Public Health

Confirming the diagnosis of tuberculosis (TB) is a major challenge, especially in very young children. For drug-resistant TB, this means that children may end up on suboptimal therapy or even on no therapy at all.
Researchers around the world have explored how to improve the diagnosis of TB in children. In this satellite session, we plan to facilitate the sharing of learnings from paediatric TB experts on how healthcare providers and  national TB programmes can improve the identification of children with TB so that they receive appropriate care.

09:45 - 10:00: Epidemiology of childhood TB and drug-resistant TB Prof Seddon will describe the current epidemiology of childhood tuberculosis

James Seddon

10:00 - 10:15: Symptom-based approach to diagnosing childhood TB. What next? Variable presentations of tuberculosis (TB) among children present a unique challenge. In many instances, objective diagnostic  modalities (eg sputum culture or molecular methods) are suboptimal so physicians have to rely on 'clinical' judgement,  supplemented by epidemiological information, to make a diagnosis. Canwe do better?

Ben Marais

10:15 - 10:30: Research agenda to improve TB treatment outcomes in children The world has made some progress in the treatment of drug-resistant tuberculosis (DR-TB) disease. It is imperative that children not be  just a footnote to this progress, but that they are included in efforts to find more effective and better tolerated drug regimen for DR-TB. 
Prof Hesseling will discuss current gaps in the treatment of childhood DR-TB, some of the ongoing research activities to address these gaps  and the way forward to ensure that children benefit from advances in the treatment of DR-TB.

Anneke Hesseling

10:30 - 10:45: Challenges in diagnosing and treating TB in children Children have been neglected in the fight against tuberculosis (TB). Despite being the number one infectious disease killer, TB does  not feature on the child survival agendas. There is need to elevate childhood TB to the top of the agenda and we do what  needs to be done to ensure that no child unnecessarily dies from TB, if we truly intend to eliminate TB.

Farhana Amanullah

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E-posters
EPTBS-TBScience 2020 - E-posters - Displayed All Conference Days
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EPTBS-TBScience 2020 - E-posters - Displayed All Conference Days
*Please scroll down for more information*
All TBScience 2020 E-posters will be displayed from 10 am Central European Summer Time (CEST), on Wednesday, 21 October for the duration of the conference and beyond

EP-TBS-01-Increased neutrophil count and decreased neutrophil CD15 expression correlate with TB disease severity and treatment response
Lerato Ndlovu

EP-TBS-02-Genome-wide identification of Mycobacterium tuberculosis genetic markers associated with the history of BCG vaccination
Kamela Charmaine S. Ng

EP-TBS-03-Characterization of regulatory B-cells for tuberculosis management
Irene Latorre

EP-TBS-04-Different antimycobacterial activity of alveolar macrophages in various lung legions of tuberculosis patients
Sergey Skornyakov

EP-TBS-05-Plasma mediators of phagocytosis in tuberculosis patients during anti-TB treatment and zinc supplementation
Victory Edem

EP-TBS-06-Discerning divergent tuberculosis endotypes: A meta-analysis of individual patient data
Andrew DiNardo

EP-TBS-07-Plasma Interferon (IFN)-g Inducible Protein 10 (IP-10) levels but not the QuantiFERON Gold plus assay correlate with disease severity and paradoxical reactions in extrapulmonary tuberculosis
Isabelle Suarez

EP-TBS-08-Host immune factors related to non-multidrug resistant tuberculosis with treatment history in Vietnam
Naoto Keicho

EP-TBS-09-Risk factors for the development of tuberculosis in children with chronic non-specific lung diseases.
Sofya Nakonechnaya

EP-TBS-10-Polyfunctional T-cells and IL-2 production decrease during pregnancy in women with latent TB infection
Jyoti Mathad

EP-TBS-11-Neutrophils Contribute to Tuberculosis-linked Inflammation and lung pathology
Caleb Nwongbouwoh Muefong

EP-TBS-12-Association of neutrophil-derived inflammatory mediator levels with lung pathology in active tuberculosis at diagnosis
Caleb Nwongbouwoh Muefong

EP-TBS-13-Characterising the BCG-induced antibody response for antigen discovery
Rachel Tanner

EP-TBS-14-ESAT-6 / CFP-10-stimulated metabolic activity of pleural fluid cells if cured tuberculosis or TB / HIV
Sergey Skornyakov

EP-TBS-15-Blood-Based Biomarkers of Tuberculosis in Children Integrating Metabolomic and Transcriptomic Data
Jeffrey A Tornheim

EP-TBS-16-Identification of TGF-β1 in pleural tuberculosis: the possible role in fibrosis
Silvio Renan Pinheiro Victor de Araújo

EP-TBS-17-Analysis of serum microRNAs as pulmonary tuberculosis biomarkers
JaeIn Jung

EP-TBS-18-Up-regulated programmed death protein 1 expression on CD4 T cells in patients with MDR-TB  associated with lung lesion and mycobacterial load
Qi Tan

EP-TBS-19-Malnutrition affects levels of vascular endothelial growth factor levels among children and adolescents with pulmonary tuberculosis?
Caio Pluvier Duarte Costa

EP-TBS-20-Towards identification of protein markers of Mycobacterium tuberculosis H37Rv extracellular vesicles (EV)
MEHALENE JAYARAM

EP-TBS-21-Increased frequency of CD39+ regulatory T cells in the pleural fluid of patients with Tuberculosisin comparison to other exudative causes
Ana Paula Santos

EP-TBS-22-Longitudinal analysis of M. tuberculosis-specific T cell responses demonstrates dynamic T cell responses to ESAT-6 and CFP-10 during pregnancy independently of mitogen responses.
Aparajita Saha

EP-TBS-23-Serum Cytokine Profile as Biomarker for Multi-drug Resistant Tuberculosis
Alahaman Nana Boakye

EP-TBS-24-Reanalysis and validation of Tuberculosis genes signature in blood and pleural fluid from patients with exudative pleural effusion
Raquel da Silva Corrêa

EP-TBS-25-TimBre, Cough based screening of Pulmonary Tuberculosis using Machine Learning that is Explainable and Interpretable
Rahul Pathri

EP-TBS-26-HbA1C as prognostic factor in PTB
Sarang Patil

EP-TBS-27-Better intradermal delivery for bacille Calmette-Guérin (BCG) vaccine by microneedles in healthy adults of S. Korea
Hyejon Lee

EP-TBS-28-MULTIPLEX BIOMARKER ASSAY FOR DETECTION OF MYCOBACTERIUM TUBERCULOSIS
Puneet Gupta

EP-TBS-29-Role of the chemokine receptor CXCR3 in the recruitment and retention of lung resident memory T cells following a pulmonary TB vaccine. 
Warwick Britton

EP-TBS-31-Benefit of Quantiferon-TB Gold plus in incidence of TB disease in Heath care workers of Central Chest Institute of Thailand
piamlarp sangsayunh

EP-TBS-32-The blood monocyte/lymphocyte, neutrophil/lymphocyte and platelet/lymphocyte ratios in children with pulmonary tuberculosis
Larissa Gorbach

EP-TBS-33-Pulmonary tuberculosis patients have an anaerobe-enriched microbiota associated with a pro-inflammatory peripheral host immune phenotype
Charissa Naidoo

EP-TBS-34-The epidemiologic impact and cost-effectiveness of new tuberculosis vaccines on rifampicin resistant and multidrug resistant tuberculosis in India and China
Chathika Weerasuriya

EP-TBS-36-Novel, culture-free, same-day TB diagnosis with ultrasensitive ELISA
Rikiya Takeuchi

EP-TBS-37-Tuberculosis screening in point-of-care settings: Proof-of-concept for a fast and easy sample-to-answer qPCR-based protocol
Alexandre Dias Tavares Costa

EP-TBS-38-Diagnostic accuracy of three urine lipoarabinomannan tuberculosis assays in HIV-negative outpatients
Tobias Broger

EP-TBS-39-To Study The Presence Of Live Mycobacterium Tuberculosis In Resected Lung Specimens Of Patients Undergoing Lung resection Surgery For Post-Tuberculosis Sequelae
Pallavi Purwar

EP-TBS-40-What can tuberculosis prevalence surveys tell us about the duration of asymptomatic bacteriologically-positive disease?
Chu-Chang Ku

EP-TBS-41-An RNA signature for tuberculosis risk in pregnant women: a prospective cohort study from India
Jyoti Mathad

EP-TBS-42-Analysis of mycobacterial trans-renal DNA for the diagnosis of Tuberculous Meningitis in adults.
Manisha Dass

EP-TBS-43-Developing a tool to identify and screen Latent Tuberculosis Infection (LTBI) with likelihood of progression to active Tuberculosis (ATB)
Prashant Singh

EP-TBS-44-QuantiFERON TB plus-negative results in clinically diagnosed paediatric tuberculosis: immune suppression or misdiagnosis?
Gloria Ivy Mensah

EP-TBS-45-Evaluation of a blood-based antigen test for tuberculosis in HIV-exposed children younger than 5 years
Tony Hu

EP-TBS-46-Adverse drug reactions in MDR TB Patients on ATT
Sarang Patil

EP-TBS-47-Species and Drug Susceptibility profile of Non-tuberculous Mycobacteria isolated from presumptive TB cases
PRIYA RAJENDRAN

EP-TBS-48-MAMA-PCR assay for the detection of point mutations associated with drug resistance in Mycobacterium tuberculosis clinical isolates
Raquel Muñiz-Salazar

EP-TBS-49-Genomic diversity in Mycobacterium tuberculosis from human lung resections reveals a high degree of multiclonal infections in a high-burden MDR-TB setting
Miguel Moreno-Molina

EP-TBS-50-Pathogen genome sequencing to guide treatment regimen designs for multidrug-resistant tuberculosis
Hans-Peter Grobbel

EP-TBS-51-An evolutionary functional genomics approach identifies novel candidate regions involved in isoniazid resistance in Mycobacterium tuberculosis
Victoria Furió

EP-TBS-52-Antibiotic Resistance Profile Determination Using Whole Genome Sequencing
Ryan Howard

EP-TBS-53-Rapid genomic drug resistance prediction from clinical Mycobacterium tuberculosis specimens using amplicon based deep sequencing based on Deeplex-MycTB
Stefan Niemann

EP-TBS-54-Multi-resistant tuberculosis and HIV infection in Kinshasa: 2011-2018. DRC “Epidemiological, clinical and therapeutic aspects”
Nicole ANSHAMBI

EP-TBS-55-Long Read DNA Sequencing of XDR/MDR Tuberculosis Samples to Investigate Factors Leading to Resistance and Virulence
Michael Harris

EP-TBS-56-Genome-wide detection of epistasis in antibiotic resistant M. tuberculosis
Anna Green

EP-TBS-57-Population structure, biogeography and transmissibility of Mycobacterium tuberculosis
Luca Freschi

EP-TBS-58-Safety and Efficacy of an MDR-TB All-oral Short-course Regimen in China: An Preliminary Analysis of the MDR-Chi clinical trial
Liang Fu

EP-TBS-59-Drug exposure and minimum inhibitory concentration predict pulmonary tuberculosis treatment response
Xubin Zheng

EP-TBS-60-A novel therapeutic vaccine against multi-drug resistant tuberculosis by T cell-immunity in phase 1 clinical trial.
Masaji Okada

EP-TBS-61-Improving the safety of TB therapy with novel diagnostic biomarkers of liver toxicity – a study in UK and Ugandan patients
Derek Sloan

EP-TBS-62-Tuberculosis meningitis mouse model
Tuhina Gupta

EP-TBS-63-Pharmacokinetics of the three-drug fixed-dose dispersible tablet in children
Aziza Pakhlavonova

EP-TBS-64-Does BCG Vaccination protect against infection with Mycobacterium tuberculosis in Vietnamese schoolchildren?
Puck Pelzer

EP-TBS-65-Time to positivity as a surrogate biomarker of time to culture conversion
Belén P. Solans

EP-TBS-66-Use of the contact management register to identify those with Active and Latent TB, Kenya, Jan-March 2020
RHODA POLA

EP-TBS-67-Predicting Efficacy Outcome of Nine Tuberculosis Drugs in Phase 2a First-in-patients Studies
Nan Zhang

EP-TBS-69-Predicting optimal treatment durations for tuberculosis patients: a risk stratification algorithm and clinical simulation tool
Marjorie Imperial

EP-TBS-70-Adverse Drug Reactions in MDR TB Patients on Category IV Regimen in Western Odisha
SUMAN KUMAR JAGATY

EP-TBS-71-The effect of antiretroviral therapy and preventive tuberculosis therapy with anti-TB drugs on the duration of TB remission in HIV-infected patients
Igor Medvinskiy

EP-TBS-72-A Urine Colorimetric Assay for Levofloxacin Concentrations and Optimized Regimen Development
Prakruti Rao

EP-TBS-73-Development and Application of an Integrated Biomarker - Clinical Endpoint Tool for Late Stage TB Regimen Development and Clinical Trial Design
Marjorie Imperial

EP-TBS-74-Leveraging Neural Networks and Imaging Experts in Loops for Automated Tuberculosis Screening Using Chest Radiographs in Population Screening Programs to ensure efficient workflows.
Amit Kharat

EP-TBS-75-A model for the integration of traditional medicine into conventional medicine for the treatment of Tuberculosis (TB) in Zimbabwe
Winnet Enerita Chipato

EP-TBS-76-Point-of-Care Saliva Assay for Levofloxacin Concentrations and Personalized Dosing in Patients with Multidrug-Resistant Tuberculosis in Tanzania
Sagal Mohamed

EP-TBS-77-PBPK Model Informed Prediction to Evaluate the Effect of Renal Impairment and OCT genotypes on the Ethambutol Disposition
Yumi Park

EP-TBS-78-Development of Population Pharmacokinetic Model of the First-line anti-TB drugs in Korean patients with TB for Therapeutic Drug Monitoring Guided Dose Adjustment
Yumi Park

EP-TBS-79-Model Informed Personalized Dosing Algorithm Development for TB Therapy in Center for Personalized Precision Medicine (cPMTb)
Yumi Park

EP-TBS-80-Classifying adherence trajectories: an innovative tool for regimen development
Stephanie Law

EP-TBS-81-Predicting pretomanid penetration into patient lesions of tuberculosis
Jacqueline Ernest

EP-TBS-82-Rifapentine pharmacokinetics and pharmacodynamics: murine and human models to identify optimal dosing for treatment of latent M. tuberculosis infection
Jacqueline Ernest

EP-TBS-83-SLCO1B1 and SLC10A1 polymorphism and plasma rifampin concentrations in patients with co-morbidity tuberculosis-diabetes mellitus in Baja California, Mexico
Ricardo Perea-Jacobo

EP-TBS-84-Individual-Level Data Meta-Analysis of Adverse Events from Clinical Trials of Drug Sensitive Tuberculosis Treatment Regimens
Leah Jarlsberg

EP-TBS-85-G-clamp-inspired ligands and their effects on G-quadruplexes from Mycobacterium tuberculosis
Egor Shitikov

EP-TBS-86-Prediction of early bacterial activity (EBA) of bedaquiline in tuberculosis
Federico Romano

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EP14-Reaching the hard-to-reach ones: strategies to overcome the challenges
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EP14-Reaching the hard-to-reach ones: strategies to overcome the challenges
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EP14-230-22-Is TB contact investigation feasible in resource-limited settings like Malawi?Tuberculosis contact investigation (TB-CI) can assist TB programmes in early detection of TB among household and close contacts. Malawi TB programme developed SoPs for TB-CI, trained frontline healthcare workers and instituted mentoring and support supervision on TB-CI. We, therefore, analysed implementation of TB-CI in Malawi from 2016 to 2019.
Henry Kanyerere

EP14-231-22-Targeted active TB case finding using mobile TB diagnostic units among key affected populations in Malawi: an innovative approach to reach the missing TB casesThis abstract demonstrates a positive impact on Malawi's innovative active tuberculosis (TB) screening intervention by using Mobile Diagnostic Units (MDU's) in high-risk, urban populations of Malawi. Lessons learned consider it as a game changer and it can be scaled-up globally to narrow the existing gap in finding the missing TB cases.  
Madalitso M'manga

EP14-232-22-Biomedical support to people affected by TB in prisons: a pilot experience in Cochabamba, BoliviaWe report on a biomedical approach in prisons for improving detection and treatment outcomes of people affected by tuberculosis (TB), which included peer support, sensitisation, diabetes screening, nutritional supplements, monthly peer support meetings and a tracking system for released inmates. This approach yields an increased number of TB confirmed and cured, compared with a period before.  
Rebeca Ledezma Almendras

EP14-233-22-Barriers to TB care among women in selected hard-to-reach areas in Southern Nigeria: a mixed method studyThis study sought to identify barriers to accessing tuberculosis (TB) services among women in hard-to-reach riverine communities in Southern Nigeria. Our findings highlight the need for more robust, gender-sensitive measures to end TB in resource-constrained settings.
Chuka Agunwa

EP14-234-22-Socioeconomic indicators predict neighborhood-level active case finding yields better than historic case notification rates in Lima, PeruWe assessed the utility of targeting (tuberculosis) TB active case finding efforts, based on areas with prior high TB case notification rates, by comparing historic case notifications with screening yields from a community-based active case finding programme using x-ray vans in Lima, Peru.
Meredith Brooks

EP14-235-22-Detection of persons with TB through innovative engagement of standalone private radiology diagnostic centres in Kaduna state, Nigeria, in 2019With low treatment coverage of 22% in Kaduna state, Nigeria, a sizeable number of people with tuberculosis (TB) are missed while patronising standalone private diagnostic centres. Tracking persons with a chest X-ray report suggestive of TB from these sites, in addition to those in the hospital-based settings, will improve TB detection. 
Dauda Samuel Hananiya

EP14-236-22-Finding the missing cases among high risk populations: Lessons from MalawiThis programme evaluation provides the effort of implementing a targeted screening of TB among high risk populations in the identification of TB missing cases in low resource settings. The implementation provides  an analysis of the cascade of TB care among high risk groups using mobile diagnostic units.
Kruger Kaswaswa

EP14-237-22-Improving access to TB services for vulnerable populations: an employer-led model demonstration in IndiaEmployers are a viable entry point to supporting populations vulnerable to tuberculosis (TB). The Employer Led Model (ELM) brought together district administration, district TB programmes and employers to demonstrate a partnership model aimed at improving awareness of TB and to increase access to services by integrating TB within the existing structure of establishments.
Anupama Srinivasan

EP14-238-22-Can mentorship and training improve the implementation of TB infection prevention and control in low-resource settings? Malawi experienceThis abstract is about an improved trend on tuberculosis (TB) infection prevention and control (IPC) indicators following the on-site mentorship and training intervention employed by Malawi National TB Control Programme (NTP). NTP-Malawi revised its TB IPC guidelines to adopt the World Health Organization guidelines in 2015. The programme reviewed the performance trend from 2015 to 2019.
Lameck Mlauzi

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E-posters
EP17-Facing TB during the COVID-19 pandemic
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EP17-Facing TB during the COVID-19 pandemic
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EP17-263-22-Overcoming challenges of sample transportation for TB testing during COVID-19 lock down, March-April 2020: an interventional study in Telangana, IndiaThe diagnostic services in tuberculosis (TB) were hampered during the COVID-19 lock down. This in turn will reduced early detection of drug-resistant TB. By utilising the available resources, such as the 104 ambulance vans at district level, the challenge of sample transportation and, thus diagnosis, of drug-resistant TB has been addressed.
sumalata Chittiboyina

EP17-264-22-TB patients through telecommunication in COVID-19 situation: BRAC experienceEvery day around 600 COVID-19 cases are diagnosed, which may increase if sample testing capacity can increase. The world is fighting to end infectious diseases. Planned and effective utilisation of resources can ensure uninterrupted tuberculosis (TB) service. However, to increase TB cases finding in a lock down situation is very challenging.
Md Abul Khair Basher

EP17-265-22-Physically distant but still in contact: telephonic counselling for rifampicin-resistant TB patients in South Africa during the COVID-19 pandemicCOVID-19 threatens to undermine progress in the global tuberculosis (TB) response by disrupting routine TB services. Here, we describe telephonic counselling offered to rifampicin-resistant TB (RR-TB) patients in South Africa during the COVID-19 pandemic. Some early benefits include support to address patients’ adherence problems and reduced patient costs in seeking RR-TB care.
Erika Mohr-Holland

EP17-266-22-Programmatic adaptations to the treatment of rifampicin-resistant TB infection in children and adolescents during COVID-19Post-exposure management services were modified in view of COVID-19. The strategy for recalling asymptomatic contacts was revised. Contacts identified as high risk were screened and initiated on treatment during a home visit or at a facility with infection control practices. Multi-month medication refills were provided; follow-up was conducted telephonically.
Erika Mohr-Holland

EP17-267-22-Collaboration in TB and COVID-19 control in Bungoma CountyThe World Health Organization (WHO) declared novel COVID-19 as a global pandemic. COVID-19 has several health system challenges which directly or indirectly affect tuberculosis (TB) services. Complementary COVID-19 and TB response is critical during this pandemic. Both diseases can utilise the capacity building efforts, surveillance and monitoring systems put in place.
Paul Lodi

EP17-268-22-Connecting the DOTS during the COVID-19 pandemic: using community structures and the private sector to establish linkages for increased TB case detection in NigeriaTo optimise social and behaviour change (SBC) efforts amidst COVID-19 restrictions and to sustain tuberculosis (TB) case identification and service delivery in the private sector, SHOPS Plus Nigeria (Sustaining Health Outcomes through the Private Sector) adjusted its SBC strategy to a community-led approach, comprised of patent and proprietary medicine vendors, community structures (mosques and churches) and private clinics.
Ayodele Iroko

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EP12-Approaches to paediatric TB prevention, diagnosis and treatment
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EP12-Approaches to paediatric TB prevention, diagnosis and treatment
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EP12-208-22-Comparison of neurocognitive assessment in children with TB Meningitis and healthy controls in Pune, IndiaTuberculosis meningitis (TBM) in children affects the brain adversely and results into neurological deficit. The study used The Mullen Scales of Early Learning (MSEL), a well-established measure, to assess neurocognitive impairment among children with TBM before treatment initiation and compared with age-sex matched, healthy controls in India.
Smita Nimkar

EP12-209-22-Effect of community-based interventions on childhood TB treatment outcomes in hard-to-reach areas of Southern NigeriaTreatment Success Rate (TSR) is an important World Health Organziation treatment outcome indicator that measures the quality of tuberculosis (TB) services. We report the effect of a community-based intervention on childhood TB treatment outcomes in hard-to-reach areas of Southern Nigeria.
Okechukwu Ezeakile

EP12-210-22-Fine needle aspiration biopsy of peripheral lymph nodes in children in a high TB incidence setting: practical experience in a referral hospitalPeripheral lymphadenopathy is common in children. We identified all children (<13 years) over a two-year period who had fine needle aspiration biopsy (FNAB) done at Tygerberg Hospital, Cape Town, and determined how well FNAB performed in routine practice in a high TB burden setting and whether children were appropriately managed.
H. Simon Schaaf

EP12-211-22-The adverse effects of prolonged home isolation on adolescents with TB in Lima, Peru: a qualitative studyPeru’s Ministry of Health mandates two months of home isolation for patients with tuberculosis (TB), despite data showing the majority become non-infectious in less time. Prolonged home isolation may negatively impact adolescents’ development. Peruvian study workers interviewed 34 adolescents with pulmonary TB and 15 health providers working in TB care.
Victoria Oliva Rapoport

EP12-212-22-Feasibility of testing paediatric samples for TB diagnosis: implications of the pre-analytical phase, lessons learned and challengesPaediatric tuberculosis (TB) remains a significant cause of death globally, mainly due to difficulties in diagnosis.  Laboratory confirmation is only obtained in a minority of cases due to the difficulty in obtaining samples. The main objective of this analysis was to evaluate the feasibility of a multisample, paediatric TB diagnostic approach.
Neide Gomes

EP12-213-22-A systematic review of the diagnostic accuracy of Xpert MTB/RIF and Xpert Ultra for the diagnosis of TB Meningitis and lymph node TB in childrenWe will discuss the results of a systematic review on the diagnostic accuracy of Xpert MTB/RIF for the diagnosis of Tuberculous Meningitis and lymph node tuberculosis (TB) in children with signs and symptoms of TB.
Alexander Kay

EP12-214-22-Paediatric TB care cascade: an assessment of knowledge, attitude and practice among healthcare providers in Pune district, IndiaThe dependency on sputum for diagnosis and the difficulty of getting it from younger children is the key challenge in the diagnosis of paediatric tuberculosis. Household contact screening and isoniazid preventive therapy are not being implemented effectively due to lack of awareness on the part of healthcare providers, especially in the private sector.
Jitesh Kuwatada

EP12-215-22-Knowledge, attitudes and practices around childhood TB among healthcare workers in sub-Saharan Africa and South-East AsiaWe share the results of a Knowledge-Attitudes-Practices (KAP) survey conducted among healthcare workers (HCWs) at district level in five resource-limited countries. Our findings show great variability in awareness and experience of childhood tuberculosis (TB) case management and highlights potential barriers and facilitators to the decentralisation of childhood TB diagnosis.
Basant Joshi

EP12-216-22-Improving child TB notification through innovative case finding approaches in hard-to-reach areas of Delta State, NigeriaDespite the high prevalence of tuberculosis (TB) in Delta State, Nigeria, the child TB proportion of all TB cases has remained low. A multipronged intervention was implemented in quarter three of 2018 to address the persistent barriers. Implementing a similar strategy nationwide in Nigeria could have a major public health impact.
Ufuoma Aduh

EP12-217-22-Progress towards updated policy guidance for World Health Organization- recommended best practices in paediatric TB/RR-TB careResults from the #StepUpforTB 2020 study show promising adoption of World Health Organization policy guidance for optimal paediatric tuberculosis (TB)/rifampicin-resistant TB (RR-TB) and latent TB infection management.  Evaluating implementation of national paediatric TB/RR-TB guidelines in routine clinical care is the next step to ensuring children and adolescents benefit from best practices.
Pilar Ustero

EP12-218-22-Reasons and routes of admission among hospitalised children and adolescents with rifampicin-resistant TB receiving treatment in South Africa’s ‘injectable-free era’Children and adolescents with rifampicin-resistant tuberculosis (RR-TB) are often hospitalised during treatment. A South African policy released in September 2018 recommended injectable-free treatment for everyone with RR-TB. We describe reasons for hospital admission among individuals <16 years of age admitted for RR-TB treatment in the injectable-free era.
Juli Switala

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EP19-Quality and modelling of TB
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EP19-Quality and modelling of TB
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EP19-278-22-Mathematical modelling of new TB diagnostics at subnational sites: evaluating the effects on health systems and patients across sites in same province with differing characteristicsDifferent tuberculosis (TB) diagnostic strategies provide different benefits and require different resources.  We collected detailed pathway data from eight sites in a single Philippine province and evaluated five diagnostic strategies at each. Strategies were evaluated from a societal and health system perspective, with factors which significantly influenced the optimum strategies identified.  
Ewan Tomeny

EP19-279-22-Social media as a tool to build capacity and efficient clinical decision making for doctors working in resource-limited settingThe clinical care of presumptive tuberculosis (TB) patients in remote areas can improve significantly by providing distance learning and effectively using social media as a tool to improve knowledge and capacity. This should be practiced in other hard-to-reach areas to provide quality care and accessible health services.
Myat Kay Khine

EP19-280-22-Access to quality TB diagnostic services in Nigeria: the role of specimen transport systemsSince 2016, the National Tuberculosis and Leprosy Control Programme (NTBLCP) adopted and implemented the policy of using GeneXpert machine as the primary TB diagnostic tool. Adoption and strengthening a mixed model for effective sputum specimen transportation system greatly increased access to quality diagnostic services, contributing to improved TB case finding.
Sani Useni

EP19-281-22-Lateral flow lipoarabinomannan test for diagnosis of TB among people living with HIV in selected health facilities in Nigeria: hype or hope?To increase tuberculosis (TB) case detection among people living with HIV (PLHIV), we evaluated the effectiveness of the lateral flow lipoarabinomannan (LF-LAM) test for TB diagnosis in PLHIV across selected states in Nigeria. Being a urine-based point-of-care- test, LF- LAM was found to bridge the diagnostic gap for PLHIV who could not produce quality sputum.
Nkiru Nwokoye

EP19-282-22-Impact of the rapid molecular test on the incidence of TB in an endemic city in the interior of São Paulo, BrazilEcological study. The Prais-Winsten autoregression method was used to classify the time trend of tuberculosis and then the interrupted time series method was used to identify whether there was a change in incidence after the beginning of diagnosis using the rapid molecular test.
Ricardo Arcêncio

EP19-283-22-Assessment of the quality management system in 23 national reference laboratories for TB in West and Central Africa using the SLIPTA toolAs part of the TB lab project coordinated by the World Health Organization's Supranational Reference Laboratory of Cotonou, the 23 National Reference Laboratories (NRLs) for tuberculosis (TB) in the West and Central Africa region were assessed between July 2019 and January 2020 using the SLIPTA (Stepwise Laboratory Improvement Process Towards Accreditation) tool.
Faridath Massou

EP19-284-22-Results from Namibia’s first TB national disease prevalence survey 2017-2018To better inform the implementation of tuberculosis (TB) control activities in Namibia, it was necessary to quantify the magnitude of the disease burden. The TB disease prevalence survey served as a tool to quantify the burden of TB in Namibia to enable improvement of TB control and, ultimately, end the TB epidemic.
Nunurai Ruswa

EP19-285-22-Bayesian latent class analysis versus composite reference standards for assessing TB pleuritis diagnostic test accuracyWe used latent class analysis to estimate the diagnostic accuracy of Xpert MTB/RIF for tuberculosis (TB) pleurisy, the most common form of extrapulmonary TB. We found that our estimates differed dramatically from accuracies derived from a variety of composite reference standards. 
Emily MacLean

EP19-286-22-A quarterly trend analysis of the contribution of the Wellness on Wheels intervention to TB case finding in Kano State, NigeriaThe aim of the study is to analyse the contribution of the Wellness on Wheels mobile diagnostic unit (WOW MDU) to case notifications in Kano state, Nigeria. The study showed that systematic screening using the WOW MDU is an effective method of increasing tuberculosis case notification rate and this can be scaled-up.
Mustapha Tukur

EP19-287-22-ARREST-TB: Accurate, Rapid, Robust and Economical diagnostic Technologies for TBWe share the significant progress made by ARREST-TB, a multilateral project funded by the EU’s Horizon 2020 programme, the Ministry of Science and High Education of Russian Federation, and India’s Department of Biotechnology, towards the development of frugal diagnostic devices for tuberculosis and drug resistance profiling.
Seshasailam Venkateswaran

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EP15-All hands on deck: key stakeholders take initiative to end TB
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EP15-All hands on deck: key stakeholders take initiative to end TB
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EP15-239-22-Schoolchildren as TB ambassadors played crucial role in fighting TB epidemic by disseminating messages of symptoms and free treatment in five districts in OdishaSchoolchildren as tuberculosis (TB) ambassadors played a crucial role in fighting the TB epidemic by disseminating messages of symptoms and free treatment among their peers, family members and neighbourhood in five National TB Programme districts of Odisha. The low cost intervention/model proved beneficial to the target population in containing TB infection and disease control.
Gayadhar Mallick

EP15-240-22-Under fives TB case finding in hard-to-reach areas - a case for MalawiThis abstract narrates the importance of integration of childhood tuberculosis (TB) in the management of childhood illnesses in hard-to- reach areas in Malawi. Capacity building sessions by village clinic providers and provision of recording and reporting tools for daily use enhances the identification of children who are at risk of TB. 
Paul Chiwenkha

EP15-241-22-Caregivers’ beliefs in anti-TB medicines in the African/Indian SHINE trialWe explored beliefs in medicines among the carers of children on anti-tuberculosis (TB) treatment (ATT) in India, South Africa, Uganda and Zambia. This was a substudy of the SHINE trial. Caregivers reported positive belief in ATT and low negative beliefs about medicine in general.
Jessica Workman

EP15-242-22-Active TB case finding in refugee camps: a right for allThis abstract narrates the positive findings on an intervention that has been implemented by volunteers in refugees camps in Malawi. The intervention focused on capacity building and motivating volunteers in tuberculosis (TB) activities.  Good collaboration and co-ordination between volunteers and health workers has shown to find missed cases in vulnerable communities.
Beatrice Mtotha_Nindi

EP15-243-22-Community volunteers: what motivates them to be part of the TB world?Community-based volunteers play a very crucial role in tuberculosis (TB) activities. In 2017, Malawi National TB Control Progamme trained volunteers in awareness creation, advocacy, sputum collection, and transportation and TB screening. Different enablers were provided to the volunteers. We, therefore, analysed the drop-out rate of these volunteers, reasons for dropping out and their needs.
Henry Kanyerere

EP15-244-22-Role of community health workers in patient-centred care for TBIntensifying community-based tuberculosis (TB) services through community health workers showed better results in increased case notification, maintaining a high treatment success rate and DOTS expansion through a patient-centred approach. It also made it easier to introduce any potential interventions successfully.
Sardar Munim Ibna Mohsin

EP15-245-22-Addressing diagnosis delay in TB patients through engagement of Lady Health Workers in PakistanTuberculosis (TB) is one of the major public health problems in Pakistan. Due to a high incidence of upper respiratory infections with overlapping symptoms, particularly productive cough, delay in diagnosis of TB is quite common. Engagement of Lady Health Workers (LHWs) can lead to early diagnosis of TB in rural communities. 
Aamna Rashid

EP15-246-22-The road mapping of the community contribution in the battle to end TB in SenegalIn Senegal, the participation of community-based organisations in the fight against tuberculosis (TB) has shown that community engagement can be a sustainable solution to end TB, especially in low-setting countries.
Alpha Diallo

EP15-247-22-Engaging dairy co-operatives to support TB patients: a pilot from rural Bihar, IndiaActive community institutions like dairy co-operatives can be a vehicle to involve citizens in tuberculosis (TB) response. Beyond awareness, it can result in support to the patient, their families and to health workers.
Manish Bhardwaj

EP15-248-22-Stakeholder perceptions on the ethics, transparency and fairness of clustered trial randomisationWe conducted cluster randomisation for a tuberculosis (TB) diagnostic trial at a public randomisation ceremony attended by site staff and national TB programme representatives. The two-step randomisation process required active stakeholder participation and engagement. Survey responses suggest that public randomisation ceremonies may help to cultivate stakeholder engagement and increase trust in randomisation.
Talemwa Nalugwa

EP15-249-22-Tribal Action Plan Fund utilisation under NTP: how does Chhattisgarh state, in India, fare to improve programme performance?Tribal Action Plan Fund utilisation under National Tuberculosis Elimination Programme: how does Chhattisgarh state, in India, fare on spending to improve National Tuberculosis Elimination Programme (NTP) performance by its budgeted Tribal Action Fund for its beneficiaries?
Gayadhar Mallick

EP15-250-22-TB in the shadow of COVID-19: India's media coverage of TB during the COVID-19 pandemicThe media plays a crucial role in setting the public health agenda by raising public awareness and building discourses that make or break governments’ policy implementation. A brief evaluation of the media coverage of tuberculosis (TB) in 2020 was conducted to document the discourse around TB before, and during, the COVID-19 pandemic.
Almas Shamim

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EP11-TB: HIV and diabetes comorbidities
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EP11-TB: HIV and diabetes comorbidities
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EP11-197-22-Implementation of a mHealth strategy to increase linkage to and engagement in HIV care among people with TB and substance use in Irkutsk, SiberiaWe implemented a mobile health intervention designed to improve linkage and engagement in care for a tuberculosis/HIV co-infected, substance-using population in Irkutsk, Siberia. We evaluated the impact of this intervention, called MOCT (Russian for ‘bridge’), on various patient adherence measures as well as clinical outcomes over six months.
Jacqueline Hodges

EP11-198-22-Concomitant hepatitis B or C infection in patients with TB in the Netherlands: results of screening specific risk groupsThe Dutch Thoracic Society recommends screening specific risk groups of tuberculosis (TB) patients for hepatitis B and C. Data on this policy has been registered in the national TB register since 2019. Results show that this policy may contribute to elimination strategies set for these diseases in the Netherlands.
Jossy van den Boogaard

EP11-199-22-Impact of universal TB screening (TB-Surge) on HIV case finding in selected facilities. Lessons from the TB-Surge intervention in Akwa Ibom State, NigeriaUniversal tuberculosis (TB) screening - TB-Surge - was implemented to find missing TB cases in health facilities in AkwaIbom, a Nigerian state with high TB-HIV burden. Based on World Health Organization recommendation, HIV testing was offered to patients with presumptive TB. Universal TB screening can contribute significantly to early HIV diagnosis and commencement of antiretroviral theory (ART). 
Chukwuemeka Austin Ihesie

EP11-200-22-An assessment of free radical oxidation of small intestine enterocyte proteins in HIV-TB co-infectionThe article is devoted to the study of free radical processes in the mucous membrane of patients with HIV-TB co-infection. It is known that these processes are intensified under conditions of hypoxia, including cytotoxic origin caused by the inflammatory response in the lung tissue.
Liliia Todoriko

EP11-201-22-Monocyte and lymphocyte ratio as a predictor of TB among people living with HIV after antiretroviral therapy initiationIt is a challenge to diagnose tuberculosis (TB) among people living with HIV (PLWH) due to many of them having atypical presentation. We have demonstrated a simple tool that can help us predict TB incidence using monocytes to lymphocytes ratio (MLR) among HIV-infected people on antiretroviral therapy (ART).
Sivaporn Gatechompol

EP11-202-22-Comorbidities in Filipino people with active-TB disease: baseline data from the Starting Anti-TB Treatment (St-ATT) cohortFilipino data on the prevalence and patterns of comorbidities of malnutrition, diabetes, hypertension and anaemia are scarce. Malnutrition (BMI <17.0 kg/m2) was a common comorbidity (23.1%) followed by diabetes (22.7%), hypertension (14.8%), then anaemia (13.4%). Having >=1 comorbidities was more common in those with drug-resistant TB than those with drug-sensitive TB (61.8% vs 54.6%, p=0.05).
Shuichi Jack Suzuki

EP11-203-22-Prevalence of disseminated TB in HIV-infected persons admitted with sepsis at a tertiary hospital in western KenyaDiagnosis of disseminated tuberculosis (TB) in Persons Living with Human Immunodeficiency Virus (PLHIV) has been a challenge especially in resource-limited settings. The World Health Organization recommends lateral flow lipoarabinomannan antigen assay (LF-LAM) to aid in the diagnosis of active TB in PLHIV. However, its uptake in Kenya is still wanting.
Caroline Gituku

EP11-204-22-Is TB a major comorbidity in adolescent girls and young women living with HIV? A case in Turkana and Homa Bay Counties, KenyaWe documented tuberculosis (TB) testing, diagnosis, treatment initiation and outcomes of adolescent girls and young women (AGYW). AGYW received a comprehensive intervention including HIV testing, antiretroviral therapy (ART) initiation and treatment monitoring as well as increased access to GeneXpert MTB/RIF testing and alcohol acid fast bacilli, plus treatment of drug-sensitive TB with fixed dose combination.

Phelix Mboya

EP11-205-22-Is it necessary to screen for TB in diabetes patients and how to do it? An endocrinologist-based questionnaire survey in Hunan Province, ChinaIs it necessary to screen for tuberculosis (TB) in diabetes patients and how to do it? Let's see what the endocrinologists think and how they do it from an endocrinologist-based questionnaire survey in Hunan Province of China.
Chengli Bei

EP11-206-22-Prevalence of malarial and HIV co-infection among TB presumptive and asymptomatic children aged <5 years in Western KenyaWhile the intersection between HIV and tuberculosis (TB) is well documented, despite the high burden globally of TB and malaria among children, co-infection data is lacking. We studied the prevalence of malaria and HIV co-infection among Kenyan children aged <5 years with presumptive TB compared to asymptomatic controls.
Mark Fajans

EP11-207-22-Incidence of hypokalemia among drug-resistant TB patients receiving delamanid-containing regimen in LesothoA delamanid-containing regimen is commonly used in Lesotho even though it belongs to group C. This is mainly due to its safety profile as well as absence of drug-drug interaction with certain antiretroviral therapy (ART) and, as such, we investigate the incidence of hypokalemia in drug-resistant tuberculosis patients receiving a delamanid-containing regimen.
Lawrence Oyewusi

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E-posters
EP13-Improving all steps of the TB cascade of care: from identification to beyond treatment
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EP13-Improving all steps of the TB cascade of care: from identification to beyond treatment
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

EP13-219-22-Six-month vital status of presumptive TB patients at 20 community health centres in UgandaPresumptive tuberculosis (TB) patients from 20 health facilities in Uganda were contacted six months after TB diagnostic evaluation to assess vital status and subsequent TB care. Patients were traced using phone numbers and address information abstracted from routine TB registers. The results showed substantial mortality among patients evaluated for TB.
Tania Reza

EP13-220-22-Pilot experience of self-administered treatment for people affected by TB in Conakry, GuineaTuberculosis (TB) incidence is estimated at 176 cases per 100,000 inhabitants in Guinea. Patients face follow-up difficulties due to recurrent infectious disease outbreaks and social unrest. The National TB Programme and Damien Foundation have piloted a self-administered treatment in order to ensure treatment adherence if circumstances hinder direct, observed treatment at a health facility.
Souleymane HASSANE HAROUNA

EP13-221-22-Pathway for TB care seeking and treatment: multicountry analysis among TB patients in Ethiopia, the Philippines and UgandaChallenges in the path to tuberculosis (TB) diagnosis and treatment vary by country and confirm the proposition that programme interventions should be tailored to the local context.  An assessment in the Philippines, Ethiopia and Uganda revealed variance in the timing between key steps in the TB cascade - health-seeking, testing and treatment initiation.
Kolawole Oyediran

EP13-222-22-Where are the men? A gender analysis of TB cases from targeted community outreaches in South-East and North-East NigeriaTargeted community outreaches for tuberculosis (TB) diagnosis were conducted in 32 communities in both South-East and North-East Nigeria. We found that, despite implementing strategies to target men, the majority of attendees were women. However, more TB cases were detected among the few men present.
Chukwuebuka Ugwu

EP13-223-22-Long-term results of surgical treatment of TB patientsA comparative multivariate study, based on four years follow-up of two groups of tuberculosis (TB) patients who were treated with and without surgery, demonstrated a high efficiency of surgical treatment in terms of reducing the likelihood of adverse long-term outcomes, such as TB death, relapse and transition to chronic TB forms.
Evgeny Belilovskiy

EP13-224-22-Patient and health system barriers to and, facilitators for, TB treatment initiation: a qualitative studyTo achieve 90% tuberculosis (TB) treatment coverage, it is important to ensure patient retention along the entire cascade of care. Our work aimed to understand patient and health system barriers to treatment initiation among patients diagnosed with TB in order to develop appropriate interventions to improve linkage to TB treatment.  
Stella Zawedde-Muyanja

EP13-225-22-Benefits and harms: the double-edged sword of active TB case finding globally, a qualitative study based on expert interviewsBenefits and harms of active tuberculosis (TB) case finding globally, a qualitative study based on expert interviews. This study can help to build a roadmap of benefits and harms to further guide decision-making processes and active case finding implementation.
Raina Klueppelberg

EP13-226-22-Patient perspectives and willingness to accept incentives for TB diagnostic evaluation in UgandaWe surveyed adult patients at community health centres in Uganda to assess attitudes/perceptions and willingness to accept varying incentive values for completing tuberculosis (TB) diagnostic evaluation. Incentives are an acceptable intervention for facilitating adherence to TB diagnostic evaluation. Targeted and context-specific socioeconomic supports are needed in order to optimise outcomes among vulnerable patients.
Jillian Kadota

EP13-227-22-Determinants of delayed diagnosis and treatment of TB in Cambodia: a mixed methods studyThe individual, sociocultural and clinical determinants of delayed diagnosis of tuberculosis (TB) in Cambodia have yet to be thoroughly examined. In this study, we aimed to explore the determinants of delayed diagnosis and treatment of TB in Cambodia.
Alvin Kuo Jing Teo

EP13-228-22-Initiation and management of drug-resistant TB patients as out-patients at a decentralised site shows excellent results thanks to a committed NDOH/NGO partnership in KwaZulu-Natal, South AfricaIn semi-rural South Africa patients are collecting treatment for drug-resistant TB closer to home by decentralising the care to new initiation sites. New regimens are prescribed and medication is dispensed on an out-patient basis from treatment initiation date, with good results.
Liesbet Ohler

EP13-229-22-Reduced nutritional risks and improved dietary pattern among multidrug-resistant TB clients enrolled in patient-centred care in Xi’an, Shaanxi Province, ChinaPatient-centred assessment, education, counselling and follow-up support to detect undernutrition early, reduce nutritional risks and improve dietary pattern among multidrug-resistant tuberculosis patients enrolled in patient-centred care in Xi’an, Shaanxi Province, China
Xiaomou He

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EP18-Scaling up TB preventive therapy: it is about time!
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EP18-Scaling up TB preventive therapy: it is about time!
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

EP18-269-22-TB contact investigation in 17 municipalities of Uganda: bringing TB screening to the household via coalition with communitiesA half of tuberculosis (TB) patients in Uganda are missed, leading to continuous transmission in a system where case finding is passive. Community-led contact tracing (CI) was done to ensure early diagnosis and increasing access.  The results demonstrate that engaging community players in designing and implementing CI is effective. Community-led visiting is recommended.
Paddy Busulwa

EP18-270-22-Breakthrough TB among people living with HIV on isoniazid preventive therapy in ZambiaUse of isoniazid preventive therapy (IPT) has proven effective in the fight against latent tuberculosis (TB) infection and prevention of progression to active TB disease in people living with HIV. However, it has been observed that there are patients who develop TB while on IPT and usually in the first month of treatment.
Sarah Nyangu

EP18-271-22-TB preventive treatment: global targets and progress to dateAt the United Nations High-Level Meeting on tuberculosis (TB) in 2018, Member States committed to provide TB preventive treatment (TPT) to at least 30 million people between 2018 and 2022. In this presentation, we report global progress and recent trends on the main indicators for the programmatic management of TPT.
Saskia Den Boon

EP18-272-22-Understanding barriers to latent TB treatment in people living with HIV in Cambodia: results from the KAP survey and facility assessment from the OPTICAM studyTuberculosis preventive therapy (TPT) coverage for people living with HIV is low (<30%) in Cambodia. Barriers from healthcare workers and facilities to prescribing (TPT) were assessed, highlighting the need for targeted training on TPT focusing on systematic TB screening, side effects and drug-drug interactions. Improving TPT drug supplies is essential to access.
Jennifer Campbell

EP18-273-22-TB preventive therapy among contacts above 5 years in line with United Nations High-level mission commitment: the journey so far in NigeriaThe new policy to place >5years (including adults) on TB preventive therapy (TPT) was recently adopted by countries at the United Nations High-Level Meeting. Gradual uptake of TPT among this populations is observed. The best method to ensure increased completion rate among this population is the use of a shorter TPT regimen.
Obioma Chijioke-Akaniro

EP18-274-22-Prevalence of latent TB infection among household contacts of TB patients in a low-resource, high burden TB/HIV settingThe proportion of interferon gamma release assay (IGRA) positive household contacts (HHCs) in Uganda that would require tuberculosis preventive therapy was unknown. In early 2020, we conducted a cross-sectional survey among 352 HHCs in the four regions of the country. Of those that participated, 32.7% had a positive IGRA test result.
Simon Muchuro

EP18-275-22-TB preventive treatment cascade among household contacts of people with TB in Western Uganda (October 2017–September 2018)Household tuberculosis (TB) contacts are at high risk for TB infection. People living HIV and children aged <5 years are at high risk for progression to TB disease and prioritised for TB preventive treatment (TPT). We examined the TPT cascade among household contacts following TB contact tracing, including HIV testing.
Monita R. Patel

EP18-276-22-Good proportion of household contact children under 5 years were TB screened but not getting preventive therapy in two regions of EthiopiaThis study assessed the extent of household contact screening and tuberculosis (TB) preventive therapy implementation in two regions of Ethiopia - SNNPR and Addis Ababa. The contact investigation was conducted for contacts of bacteriologically-confirmed index pulmonary TB patients and the TB preventive therapy was provided for eligible children aged under 5 years.
Abdulsemed Umar

EP18-277-22-Implementation and scale-up of TB preventive treatment among people living with HIV, South Sudan, 2018–2020Tuberculosis preventive treatment (TPT) decreases tuberculosis incidence and mortality among people living with HIV (PLHIV). In South Sudan, staff from the Ministry of Health and the US President’s Emergency Plan for AIDS Relief overcame barriers to TPT implementation among PLHIV during 2018–2020.
Dennis Kenyi Lodiongo

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EP16-TB: new insights on cost and cost-effectiveness
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EP16-TB: new insights on cost and cost-effectiveness
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

EP16-251-22-Standardised framework for evaluating the cost-effectiveness of TB case finding and treatment initiation projectsInterventions that streamline and reduce gaps in the tuberculosis (TB) care cascade can play crucial roles in TB control efforts. However, such interventions are often operationally complex and resource intensive. There is a need to better understand their costs and cost-effectiveness to support decisions for future funding, strategic adoption and programme scale-up.
Isabella Gomes

EP16-252-22-Interferon gamma release assay is a cost-effective option for provision of TB preventive therapy in high-burden, resource-limited settingsCost-effectiveness analysis is needed to inform the adoption of interferon gamma release assay (IGRA) for diagnosing latent tuberculosis (TB) in resource-limited settings. A feasibility study in Uganda shows that IGRA is cost-effective per TB disease and infection averted and, therefore, a viable option for resource-limited settings.
Simon Muchuro

EP16-253-22-Pretreatment costs for TB patients: results from an observational cohort study in Johannesburg, South AfricaTuberculosis (TB) patients the world over are faced not only with the infection itself, but also the medical and non-medical costs associated with seeking care. This abstract describes the direct (out-of-pocket) payment that patients incur before TB treatment initiation as well as highlights the sequence of providers seen.
Kamban Hirasen

EP16-254-22-The costs of providing TB services in healthcare facilities in Kenya: a case for investment to end TBThe Kenyan National Tuberculosis (TB), Leprosy and Lung Disease Program conducted a comprehensive costing study for tuberculosis (TB) service delivery. The unit costs for all TB interventions and services will inform future budgeting processes and national strategic planning in Kenya.
Angela Kairu

EP16-255-22-The cost of reaching agricultural workers for TB prevention and treatment services in South AfricaGiven occupational exposures and distances from health facilities, agricultural workers are at special risk for tuberculosis (TB) in South Africa. We implemented a community and workplace-based outreach, screening and adherence support intervention. This model offers a cost-efficient solution for active case finding among key populations.
Alexander Moran

EP16-256-22-Cost-effectiveness analysis of three tuberculosis (TB) case detection methods implemented in South West Nigeria State of Lagos, Oyo and OsunIt is a cross-sectional study designed to evaluate the cost-effectiveness of three different tuberculosis (TB) case detection methods in South West Nigeria. Household contact tracing with routine passive case detection is the most cost-effective approach to detect new TB cases, compared with house-to-house campaign and private facility incentive methods.
Muse Olatunbosun Fadeyi

EP16-257-22-An evaluation of the feasibility and costs associated with a private sector engagement pilot for pharmacies in Ho Chi Minh City, Viet NamPharmacies represent the initial care seeking point for a large proportion of people with tuberculosis (TB), yet this category of providers had not been systematically engaged in Viet Nam. We evaluated the feasibility and costs of a pharmacy engagement pilot which used the SwipeRx social networking app to make diagnostic referrals.
Tran Phuong TM

EP16-258-22-Cost-effectiveness analysis of nine-month MDR-TB treatment regimen as evaluated within the STREAM trial. Further presentation of differences in food supplement spending and working hours disaggregated by sexThe STREAM 1 trial demonstrated that the short regimen reduced health system costs and was associated with an earlier return to work and a reduction in supplementary food spending. We are now presenting the food supplement and working hours data, dissagregated by sex, and the probabilistic estimates of the likelihood that the short regimen is cost-effective.
Laura Rosu

EP16-259-22-Cost analysis of the diagnostic cascade among patients with presumed pulmonary TB searching for care at a public health centre in Rio de Janeiro, BrazilThe reduction of socioeconomic inequities is a priority for the elimination of tuberculosis (TB).  We aimed to analyse the direct and indirect costs incurred in the diagnosis of pulmonary TB among patients with presumed TB searching for care at a public health centre in Rio de Janeiro, Brazil.     
Adriana da Silva Rezende Moreira

EP16-260-22-Setting chest X-ray abnormality thresholds to conduct validation of artificial intelligence vendors and ensure targeted and cost-effective GeneXpert testing for abnormal X-ray personsIn settings where artificial intelligence (AI) is used as a screening aid, the probability of having tuberculosis (TB) determines if a patient will be referred for GeneXpert testing. Setting the right probability threshold can validate AI software and ensure the minimum number of tests are conducted to find the maximum number of patients.
Akash Malhotra

EP16-261-22-Charging user fees is not a predictor of the number of TB cases detected among private health facilities in NigeriaThe United States Agency for International Development's (USAID) Plus SHOPS (Sustaining Health Outcomes through Private Sector) Nigeria initiative supports screening and testing tuberculosis (TB) clients in clinical facilities to increase access to care through the private sector. Facilities are allowed to charge for care. We hypothesised that charging fees is not associated with higher/lower TB case detection and used programme data to validate.
Bolanle Olusola-Faleye

EP16-262-22-Cost-effectiveness analysis of proposed TB diagnostic algorithm using the loop-mediated isothermal amplification among presumptive TB patients in the PhilippinesThis paper is an economic evaluation study of different diagnostic tools used among healthcare facilities under the tuberculosis (TB) control programme in the Philippines. DSSM as the conventional method, GeneXpert a rapid molecular test and PURE-TB LAMP (loop-mediated isothermal amplification) as a novel molecular point of care test.
Rosarie Villabito Gabuya

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Community Connect
Identifying and Overcoming Legal and Social Barriers to Access in Asia
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Identifying and Overcoming Legal and Social Barriers to Access in Asia
Community, Rights and Gender Assessments have been undertaken in Bangladesh, India and Indonesia - as a partnership between TB survivors, civil society, national TB Programme and Stop TB. These assessments have identified barriers to access and laid foundations for follow up work, including CRG Action Plans, Gender Frameworks and community led initiatives to help overcome the barriers identified. This session will being together stakeholders from each of the three focus countries to unpack the experiences and lessons learned from these assessments, and subsequent work, which can help other countries to get on track to achieve CRG related UNHLM TB targets and commitments.

Co-chaired by Stop TB and Stop TB NGO Delegation
Ms. Ani Hernasari, TB Survivor & PHD Candidate, POP TB, Indonesia
Dr Kuldeep Singh Sachdeva, Deputy Director General, Head Central TB Division, India
Dr Imran Pambudi, National TB Programme Manager, Indonesia
Dr Rupali Sisir Banu, National TB Programme Coordinator Bangladesh
Dr Ramya Ananthakrishnan, Director, REACH, India
Mr Abhishek Kumar, TB survivor, India
Dr Heny Akhmad, Director, Stop TB Partnership Indonesia
Dr Akramul Islam, Director, BRAC, Bangladesh
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Channel 2
SP-15-Short, all-oral regimens for rifampicin-resistant TB: progress towards programmatic implementation at country level.
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SP-15-Short, all-oral regimens for rifampicin-resistant TB: progress towards programmatic implementation at country level.
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In March 2019, the World Health Organization (WHO) consolidated guidelines on rifampicin-resistant tuberculosis (RR-TB) included the recommendation that modified all-oral regimens to treat RR-TB should be adopted under operational research conditions.  Based on newly available data, the WHO released a Rapid Communication in December 2019 that recommended a specific all-oral, bedaquiline-containing regimen for programmatic use.  This workshop shares insights from countries that have early programmatic or operational research experience with all-oral shorter RR-TB treatment regimens, with particular focus on implementation planning and interim treatment outcomes.  

11:00 - 11:05: Introduction

11:05 - 11:17: Early adoption of a modified, all-oral shorter rifampicin-resistant TB regimen with group A and group B drugs in GeorgiaGiven a high prevalence of intolerance/confirmed resistance to several drugs in the standardised, injectable-based shorter regimen, Georgia initiated guideline revisions and protocol development after the World Health Organization consolidated guidelines in December 2018. In addition to guidance for longer, all-oral rifampicin-resistant TB regimens, national guidelines recommend a modified, all-oral shorter regimen (mSTR) of bedaquiline/linezolid/levofloxacin/clofazimine/cycloserine for nine months, with delamanid substitution for toxicities.  The guidelines and protocol were submitted to the Ministry of Health in January 2019, approved in June 2019, and fully implemented the same month.  To ensure rapid transition, drug quantification and ordering, along with training for all clinicians and staff, took place in parallel to approval processes.  While national policy allows use of mSTR programmatically, Georgia is committed to evidence generation as part of the World Health Organization Euro’s operational research initiative. As of April 2020, 106 patients have received mSTR; 17 have completed treatment with cure, 2 lost to follow-up, and 87 remain on treatment.
Nino Lomtadze

11:17 - 11:29: Rapid implementation of an all-oral, shorter rifampicin-resistant TB regimen during the COVID-19 pandemic in the PhilippinesTo improve on successful treatment outcomes of 58% in patients with rifampicin-resistant tuberculosis (RR-TB) in 2016, the Philippines introduced the standardised, injectable-based shorter regimen (SSTR) in January 2017 under programme conditions.  Treatment success of 68% for patients receiving the SSTR in 2017, revealed high rates of lost to follow up primarily due to adverse events from the injectable agent.  The national TB control programme met in January 2020 to plan the transition to an all-oral,shorter regimen based on the World Health Organization's December 2019 Rapid Communication; a departmental memorandum in February 2020 mandated all health facilities providing drug-resistant TB services to implement a standardised, shorter, all-oral bedaquiline based RR-TB regimen (SSOR) by 1 March 2020. Additional orientation and training on the guideline update were provided March-April 2020. Despite the evolving COVID-19 pandemic, within one month from release of local guidelines, there are more than 150 patients enrolled on SSOR in the Philippines.
Mary Rosary Santiago

11:29 - 11:41: Adopting best practices in rifampicin-resistant TB management in Zambia: implementation of WHO recommendations for all-oral RR-TB regimensOf the 507 patients started on treatment in Zambia in 2018, 357 (70%) started on the 2016 World Health Organization (WHO) recommended standardised shorter regimen, 132 (26%) started on a longer, conventional regimen, and 18 (4%) started on an individualised regimen with bedaquiline. By the end of second quarter 2019, 60% of all patients started on rifampicin-resistant TB (RR-TB) treatment were receiving a fully oral, bedaquiline-based longer regimen.  The National TB Programme of Zambia has kept pace with WHO recommendations, most recently with an addendum to the national RR-TB guidelines, finalised in September 2019, with immediate plans to phase out the injectable- based shorter regimen and move to fully-oral regimens for a majority of newly diagnosed RR-TB patients. By the start of 2020, all RR-TB patients are being commenced on injectable-free regimens. This presentation will describe the subsequent transition from injectable agents to bedaquiline, within the shorter regimen, from the perspective of clinicians and patients. 
Patrick Lungu

11:41 - 11:53: Impact of the COVID-19 pandemic on full implementation of all-oral shorter RR-TB regimens in PakistanThe National TB Programme (NTP) is among the lead countries with prompt implementation of World Health Organization (WHO) rifampicin- resistant/multidrug-resistant TB(RR/MDR-TB) recommendations and guidelines whenever required. The all-oral, longer treatment regimen containing bedaquiline was initiated in July 2019, with over 900 patients having received bedaquiline by December 2019. Following the issuing of WHO's Rapid Communication on the use of an all-oral, shorter treatment regimen in the same month, the NTP subsequently circulated an advisory in January 2020 to start enrolling eligible patients on a shorter regimen containing bedaquiline instead of amikacin. The advisory was immediately put into implementation at all 33 PMDT sites across the country. However, due to the emergence of the current COVID-19 pandemic in Pakistan, enrolments on the all-oral, shorter regimen have not met full potential and the pandemic response is seen as a huge challenge in optimum implementation.  
Abdul Ghafoor

11:53 - 12:20: Q&A session

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SP-17-Detecting TB among people living with HIV: updated options with updated guidance
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SP-17-Detecting TB among people living with HIV: updated options with updated guidance
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The World Health Organization (WHO) and the Stop TB Partnership’s Global Laboratory Initiative recently updated policies, recommendations and resources for tuberculosis (TB) diagnostic testing for persons living with HIV (PLHIV). Implementation of WHO endorsed rapid molecular diagnostic assays and a urine based, rapid lateral flow assay must now shift to optimally detect TB among PLHIV. Expansion of TB diagnostic landscapes across test types, locations and sub-populations increases opportunity for patients and complexity for TB programmes. In this session, speakers will share their expertise and experience with the updates and directly interact with participants through audience polling and remote question and answer tools.

11:05 - 11:15: The TB-HIV testing landscape: World Health Organization policy updatesIn 2018, an estimated 0.86 million (8.6%) of the 10.0 million people who developed tuberculosis (TB) worldwide were HIV-positive. Traditional diagnostic methods often are less sensitive in HIV-positive TB patients, as these patients often have paucibacillary forms of TB. Unlike traditional diagnostic methods, urinary LAM assays demonstrate improved sensitivity for the diagnosis of TB among this group of patients. In May 2019 the World Health Organization (WHO) convened a Guideline Development Group (GDG) meeting, where the evidence on use of commercially available urinary LAM test were evaluated. The outcome was extending WHO recommendations on use of the test to broader groups of people living with HIV (PLHIV). Conventional NAAT tests are recommended for PLHIV as well. In December 2019 WHO convened a GDG meeting, where the evidence on use of several NAATs was evaluated and recommendations updated. Xpert MTB/RIF, Xpert Ultra, Truenat MTB, MTB Plus, MTB-RIF Dx were recommended for broader patients groups, including PLHIV.
Alexei Korobitsyn

11:15 - 11:25: How? Practical global laboratory initiative resources to support updated WHO TB-HIV testing guidanceOn behalf of the Stop TB partnership’s Global Laboratory Initiative (GLI), Dr Heather Alexander will review GLI resources to support countries to review, implement and ensure quality for TB-HIV diagnostic testing strategies, policies, algorithms and networks. Highlights will include presentation of the GLI TB diagnostics implementation manual, the revised TB model algorithm for persons living with HIV and the practical guide for TB LAM implementation. Polling with be used throughout the presentation to review anonymous audience familiarity with up-to-date TB-HIV testing concepts and resources, and provide real-time feedback to GLI on themes of interest for further support. Participant responses may be used to guide live GLI website review of materials and resources for audience familiarity and quick reference.
Heather Alexander

11:25 - 11:35: Xpert MTB/RIF Ultra and LF-LAM: lessons learned from South AfricaSouth Africa is an early adopter of new tuberculosis (TB) tools. Two such diagnostics implemented are the Xpert MTB/RIF Ultra and the LF-LAM. Whilst the improved sensitivity of the Xpert MTB/RIF Ultra allows detection of more cases, a challenge emerged in managing a ‘trace’ result especially in light of the high proportion of previously treated TB in the country. Using the preliminary findings of the national TB prevalence survey an algorithm, addressing the management of Xpert Ultra ‘trace’ results, was developed and will be shared.
The LF-LAM testing algorithm for people living with HIV was developed in 2018 through National TB Think, taking into account clinical considerations. Training was initiated nationwide, for a roll out as a point of care diagnostic, and introduced in a phased approach. Several challenges have hampered implementation: kit availability, recording of results, competency in performing the test, task shifting etc. A hybrid model is now considered.
Farzana Ismail

11:35 - 11:45: Molbio Diagnostics Truenat™ MTB, MTB Plus and MTB-RIF: lessons Learned from IndiaMolbio Diagnostics (India) has developed chip-based RT-PCR assays for detection of tuberculosis (TB) i.e. Truenat™ MTB and the MTB-RIF Dx reflex assay for detection of RIF resistance. Basis interim data from a FIND coordinated multicentric, prospective field evaluation study, the performance of Truenat MTB, MTB Plus and MTB-RIF Dx assays showed comparable accuracy with Xpert MTB/RIF and Xpert MTB/RIF Ultra for TB detection and for sequential rifampicin resistance detection (WHO 2020). Truenat has been approved for use by India’s National TB Elimination Programme (NTEP) as a potential replacement for the smear microscopy test. There are currently 300+ Truenat platforms in India with a majority of them in the southern state of Andhra Pradesh. The Government of India is in the process of adding another ~1500 Truenat machines within the NTEP. The presentation will focus on the initial learnings from implementation that can be leveraged for a successful national, and potentially international, scale-up.
Sanjay Sarin

11:45 - 11:55: Challenges with maintaining quality of TB Xpert results in a low-resource countryAs tuberculosis (TB) diagnostic networks expand in test scope across far-reaching geography and across tiers of the laboratory network, additional resources are needed to ensure that accurate, reliable and timely test results are produced. Since 2011, the TB Xpert diagnostic network has expanded significantly in Uganda to include 250 testing sites that have evolved from use of the Xpert MTB/RIF assay to the more sensitive, Xpert MTB/RIF Ultra. Quality assurance efforts have had to similarly expand to support training at the site, and above site, levels of production and use of quality management system documentation, conductance of internal and external quality assurance activities, and that all efforts are matched with appropriate monitoring, evaluation and corrective action, as needed. In a resource-limited setting, these dual expansions challenge the health system and programme and require innovative approaches for support.
Moses Joloba

11:55 - 12:20: Q&A session

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SP-18-The work of the WHO European Laboratory Initiative on TB, HIV and viral hepatitis
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SP-18-The work of the WHO European Laboratory Initiative on TB, HIV and viral hepatitis
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This session describes activities of the World Health Organization (WHO) European Laboratory Initiative (ELI) with emphasis on development of integrative capacity to diagnose multiple diseases including, most recently, SARS-CoV-2. The ELI has developed and implemented policy statements for diagnostic and therapeutic integration, diagnostic algorithms, biosafety training, electronic external quality assurance dashboards for drug-resistant tuberculosis (TB), online training courses for the use and interpretation of WHO recommended rapid molecular techniques, and determined European laboratory readiness for the diagnosis of resistance to the drugs within the new multidrug-resistant TB treatment regimens, removal of western blot testing for HIV, and building behavioural science approaches into guidance strategies.

11:00 - 11:05: Introduction

11:05 - 11:15: European Laboratory Initiative (ELI) on TB, HIV and viral Hepatitis: supporting countries of the WHO European Region on integrated laboratory capacity building strategiesThe WHO European Region established the European Laboratory Initiative in 2012, in collaboration with the Global Laboratory Initiative, to strengthen laboratory capacities for accurate diagnosis and early detection of TB and drug resistant TB in the WHO European Region.
In 2018, ELI’s mission was expanded to upscale the detection of TB/HIV coinfection, HIV and viral hepatitis, with the ultimate objective of strengthening and making more efficient use of existing capacities for all 3 diseases.
During the COVID-19 pandemic this integrative capacity building approach has proven to be beneficial not only for TB, HIV and viral Hepatitis but also for SARS-CoV-2 testing. This presentation gives an overview of the Eli's activities.
Soudeh EHSANI

11:15 - 11:25: Algorithm for laboratory diagnosis and treatment monitoring of pulmonary TB and drug-resistant TB using state-of-the-art rapid molecular diagnostic technologiesThe World Health Organization (WHO) European Laboratory Initiative (ELI) has produced a key technical document describing how tuberculosis (TB) laboratories and programmes in the WHO European Region can increase the timely and accurate detection of TB and multidrug-resistant TB. The approach emphasises the importance of molecular-based diagnostics through the use of detailed algorithms for diagnostic and treatment progression. It helps laboratories and clinicians improve their joint understanding of what the test results mean, their limitations and the therapeutic actions that follow. It builds on the ELI online courses which provide practical training on the interpretation of WHO-endorsed tests for drug-resistant TB.
Francis Drobniewski

11:25 - 11:35: European Laboratory Initiative online course on drug-resistant TB: how to interpret rapid molecular test resultsThe European Laboratory Initiative for tuberculosis (TB), HIV and viral hepatitis has recently launched a free online course that provides practical guidance and expert advice on the interpretation of selected World Health Organization-endorsed tests for drug-resistant TB. More specifically, it covers the latest guidance for the interpretation of rapid molecular drug-susceptibility testing assays by Cepheid (GeneXpert MTB/RIF and GeneXpert MTB/RIF Ultra) and Hain Lifescience (GenoTypeMTBDRplus VER 2.0 and GenoTypeMTBDRsl VER 2.0). This presentation will introduce the course, assess its reception to date and outline future plans.

Claudio Koeser

11:35 - 11:45: Integration of multi-disease testing platforms for infectious diseases to maximise the benefit in time of need: using TB, HIV, and hepatitis C as an example.The presentation will focus on the role that integrated diagnosis and monitoring responses can have in the region as a means to provide high quality, more person-centred services, making use of the systems already in place. Drawing on examples from tuberculosis, HIV and hepatitis C, it will reflect on opportunities and barriers moving forward, and provide examples of how systems can adjust in order to provide more effective responses.

Daniel Simoes

11:45 - 11:55: External quality assurance dashboard for TB drug-susceptibility testing: why a once-a-year evaluation is insufficient to guarantee for quality drug susceptibility testing resultsThe use of World Health Organization-recommended new anti-tuberculosis (TB) medications is emphasised in the new guidelines. High quality drug susceptibility testing (DST) and high DST coverage for notified TB cases is required. There is a global challenge with the number of bacteriologically-confirmed notified TB cases, despite excellent annual panel testing results. To ensure the quality of phenotypic DST and to verify the steps of diagnostic process, a comprehensive DST assessment tool has been developed to be used in future independently by laboratory workers. The tool aims to identify gaps and suggest ways to improve the drug susceptibility testing: i) evaluation of the performance and role of the laboratory in bacteriological confirmation among notified TB cases; ii) quick identification of weak points in the existing laboratory workflow; iii) recommendations for laboratory development; iv) standardisation of assessment process, uniform results; v) help in implementation of the recommended algorithm and laboratory quality indicators calculation.

Natalia Shubladze

11:55 - 12:20: Q&A session

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SP-16-Health system response preventing TB and tobacco: lessons learned from COVID-19
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SP-16-Health system response preventing TB and tobacco: lessons learned from COVID-19
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The unprecedented crisis of COVID-19 warned the health system of its poor preparedness to combat any pandemic globally. Tobacco and tuberculosis (TB) are major global public health problems. Each year, tobacco kills around 8 million people and TB kills about 1.8 million. Evidences suggest that there is a deadly combination between TB and tobacco.  Emerging data shows that smokers and people with non-communicable diseases are more likely to suffer severe COVID-19 illness. The World Health Organization has estimated that eliminating smoking could reduce TB rates by as much as 20 percent. Government’s preparedness with adequate resources, cessation, prevention policies and taxation are critical to end TB and tobacco.

11:00 - 11:05: Introduction

11:05 - 11:15: The Union approach in establishing tobacco control into health systemsTobacco smoking appears to be an important and entirely avoidable risk factor for a poorer prognosis in COVID-19. COVID-19 has not only severely constrained health systems but with the looming danger of economic recession, it becomes even more vital to avert the huge financial cost of tobacco use to the global economy. The urgency to prioritise stronger action on integration of tuberculosis (TB) and tobacco control measures are mandatory. The Union approach ABC (ask, brief advice, cessation support) can be universally applied as it has produced more than 60% smoking quit rates among people with TB in India, Indonesia, China, Bangladesh and Philippines. Time to scale-up.
Tara Singh Bam

11:15 - 11:25: How effective is the systemic integration of smoking cessation into TB control programmes in creating smoke-free environments in Manila?We conducted a prospective observational study with an intervention group comprised of tuberculosis (TB) patients, receiving the modified ABC (ask, brief advice, cessation support) smoking cessation approach, and a control group receiving only regular health education, at selected health centres in Manila City. We enrolled 1,144 and 1,030 TB patients as an intervention and a control group, respectively. Tobacco smoking rates at registration indicated no significant difference between the groups, 31.6% vs. 27.3%, respectively. Both tobacco smoking and second-hand smoking rates throughout the TB treatment period were lower in the intervention group than in the control group. In contrast, there was no significant difference in TB treatment success rate between these groups, 85.0% vs.87.3% (P=0.201), respectively and the self-claimed health status at month 12 (P=0.132).
Akihiro Ohkado

11:25 - 11:35: COVID-19: a window of opportunity to prompt tobacco cessationAn initiative from academia, professional associations and civil society from several Latin American countries and Spain regarding COVID-19 and tobacco use will be presented. We prepared an evidence-based position statement focused on two questions: do smokers have higher risk of acquiring SARS-COV-2 infection and developing COVID-19?  And, do they have a more acute progression or a worse prognosis? The document was disseminated through webs, social media and traditional media, placing tobacco cessation on the COVID-19 agenda. As a result of this initiative, further steps regarding tobacco cessation and tobacco surveillance in the COVID- 19 contingency were achieved.
Maria Laura Llambi

11:35 - 11:45: Workplace-based health education strongly associated with improved knowledge of tobacco harm and reduced SHS exposureA cross-sectional study was conducted among 14,195 employees with, and without, previously treated tuberculosis (TB) in China. Findings show that health education was strongly associated with better awareness of tobacco harm (OR=1.81, 95% CI 1.64-2.00, P<0.05), lower odds of SHS exposure (OR=0.79, 95% CI 0.74-0.85, P<0.05), higher odds of perceived working in a healthy environment (OR=1.75, 95% CI 1.61-1.90, P<0.05) and improved health information seeking behaviour (OR=1.71, 95% CI 1.59-1.84, P<0.05). In a further analysis of those employees with a leading role in the company as a category variable, it showed significantly an association with perceived working in a healthy environment (OR=1.44, 95% CI 1.20-1.73, P<0.05) and improved health information seeking behaviour (OR=1.24, 95% CI 1.06-1.44, P<0.05). This study demonstrates positive association of health education with improved awareness of tobacco harm, lower SHS exposure and better health information seeking behaviour. Policy makers need to give attention to health education as a strategy for building smoke-free environments.
Yan Lin

11:45 - 11:55: Tobacco cessation among people with TB in Dhaka, BangladeshAn intervention of tobacco cessation in people with tuberculosis (TB) was made with the support of the national TB programme in Dhaka city. Frontline health workers identified tobacco users and level of addiction to tobacco, through interview. Every patient with a history of tobacco use was registered for counselling for tobacco cessation. Brief advice was given at registration and follow-up visits (2/3, 5, 6 months). In 2018 and 2019, a total of 13,579 patients were registered in BRAC support TB centres. Of them, 3012 patients were tobacco users (86% male, 14% female). Of the total tobacco users, 938 (31%) have high level of tobacco addiction and 2074 (69%) have low level of tobacco addiction. At the end of treatment, a total of 1716 (57%) TB patients quit tobacco use. This simple intervention could help to stop tobacco use in over 505 of the TB patients at the end of treatment.
Md Akramul Islam

11:55 - 12:20: Q&A session

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OA-11-New solutions to old TB challenges
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11:00 - 11:05: Introduction


11:05 - 11:13: OA-11-563-22-Comparison of three bacteriological methods of Mycobacterium tuberculosis in cerebrospinal fluid Detection of cell-free DNA of pathogens has got good results in the diagnosis studies of various diseases. We prospectively detect the cell-free DNA of Mycobacterium tuberculosis (MTB), culture and Xpert MTB/RIF in cerebrospinal fluid of patients with tuberculous meningitis (TBM) and evaluated the diagnostic value of this three methods for TBM.

Xuelian Li

11:13 - 11:21: OA-11-564-22-Non-invasive respiratory aerosol sampling using masks for detection of pulmonary TB in children The development of a non-invasive sampling method for paediatric tuberculosis (TB) diagnosis is a priority research area. Respiratory aerosols collected on patients masks can be a simple and non-invasive source for diagnosis. This study provides a proof of concept that respiratory aerosols can be used for detection of pulmonary TB in children.

Kalpana Sriraman

11:21 - 11:29: OA-11-565-22-Stool-based Xpert Ultra testing for childhood TB in Kampala, Uganda We evaluated the performance of a centrifuge-free, rapid stool processing kit for the diagnosis of pulmonary tuberculosis in children using the Xpert MTB/RIF Ultra assay. We present the diagnostic accuracy among children prospectively enrolled in Kampala, Uganda, and added yield with a repeat test.

Mariam Nakabuye

11:29 - 11:37: OA-11-566-22-Development of a treatment decision algorithm for HIV-uninfected children with presumptive pulmonary TB We developed treatment decision algorithms and demonstrated that, clinical history and examination, provides sufficient evidence to make a treatment decision for pulmonary tuberculosis (TB) without chest radiography and Xpert. Starting more children on anti-TB treatment, based on clinical evidence, will contribute substantially to reducing TB mortality in children globally.

Kenneth Gunasekera

11:37 - 11:45: OA-11-567-22-Evaluation of mycobacterial smart probes: novel fluorescent probes for the detection of live mycobacteria in diagnostic samples The study focuses on the development of a new method for rapid screening of tuberculosis (TB) - new fluorescent dyes incorporated into the mycobacteria cell wall. At the University of Edinburgh, novel trehalose-based fluorescent probes (mycobacterial smart probes) were developed and evaluated in CTRI (Moscow, Russia).

Assel Baibek

11:45 - 11:53: OA-11-568-22-Identification and validation of efflux pump inhibitors against Rv1218c in multidrug-resistant TB clinical isolates To prevent resistance mediated by efflux pumps, designing inhibitors which in turn increases the activity of the antibiotics. Rv1218c is a major ABC transporter which causes efflux of multiple substrates, novobiocins and pyridines. We identified raffinose and palmitic acid as a potent efflux pump inhibitor, reducing the MICs of RMP.

Rajesh Mondal

11:53 - 12:20: Q&A


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OA-10-Partnerships for integrating services
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11:00 - 11:05: Introduction


11:05 - 11:13: OA-10-556-22-Engaging private healthcare providers to intensify TB case detection Private healthcare providers play a key role in tuberculosis (TB) referral, diagnosis and treatment. Engaging them effectively can help to close the TB notification gap and ensure that patients receive proper TB care.

Rajesh Sah

11:13 - 11:21: OA-10-557-22-Rational medicine use when presented with TB symptoms: private sector prescribing practices in two urban regions of South Africa Are South African patients with tuberculosis (TB) and TB-HIV, who present to the private sector, diagnosed efficiently and effectively? Do they receive care that is of an acceptable cost to them and their community? We explore prescribing practices of private GPs and the potential contributors to TB diagnostic delay and antimicrobial drug resistance.

Angela Salomon

11:21 - 11:29: OA-10-558-22-Engaging informal providers to screen and refer TB presumptive cases for formal TB diagnosis: use of barcode sticker system to refer TB presumptives The Clinton Health Access Initiative (CHAI) and the national TB programme developed a systematic package of actively engaging traditional healers, pharmacies and drug stores to actively screen, refer and follow up TB presumptives for formal TB diagnosis at the facility in two districts in Malawi. It demonstrated the potential to increase TB notifications.

Godwin Nyirenda

11:29 - 11:37: OA-10-559-22-Integrating services of TB, HIV/AIDS and malaria at the community level: lessons from community systems', strengthening pilot project in Kenya Delivering  health services for each condition separately, contributes to fragmented service delivery at the community level. This abstract is about assessing the possibility of integrating services for tuberculosis, HIV/AIDS and malaria at the community level, and monitoring if there was improvement in performance of the health indicators.

Paul Maleya

11:37 - 11:45: OA-10-560-22-Adherence to TB screening and treatment initiation guidelines in urban Nigeria: a study of TB care quality among private clinical providers in two states A study of private clinical providers’ management of presumptive and confirmed TB patients in urban Nigeria - using standardised patient and vignette survey methodology - reveals a minority of providers were able to demonstrate fully correct case management. Bottlenecks to correct management include provision, or referral, for diagnostics and counselling for confirmed patients.

Lauren Rosapep

11:45 - 11:53: OA-10-561-22-Provider-initiated active TB case finding in high volume, healthcare facilities: preliminary results from an ongoing project in Nigeria KNCV Nigeria's active tuberculosis (TB) case finding project, which is funded by the United States Agency for International Development, introduced provider–initiated TB case finding in health facilities. Designated screening officers and facility staff were trained on the use of a symptom checklist for TB screening in order to identify presumptive TB, linkage for diagnostic evaluation and treatment for confirmed TB cases.

Ogoamaka Chukwuogo

11:53 - 12:01: OA-10-562-22-Significant boost needed to ensure sustainable procurement by governments of WHO-recommended TB medicines in high burden countries while shifting from donor-supported to domestically-funded procurement While countries are increasingly required to purchase tuberculosis (TB) medicines with domestic funds, access to all World Health Organization (WHO) recommended TB medicines is not secured. Local registration of at least one source meeting WHO quality standards, up-to-date nEMLs, transparent national tenders. More focused technical assistance from donors and WHO is urgently required.

Christophe Perrin

12:01 - 12:20: Q&A


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OA-12-Confronting TB stigma
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OA-12-Confronting TB stigma
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12:30 - 12:35: Introduction


12:35 - 12:43: OA-12-569-22-Why is TB called the ‘disease of paper’? Exploring perceptions about the spread of TB in rural South Africa Understanding community perceptions of tuberculosis (TB) spread is valuable to informing clear communication during health visits. People diagnosed with TB can be subjected to ineffective and stigmatising TB infection control practices at home. Health workers need to proactively provide information to families and people diagnosed with TB in order to prevent discrimination.

Helene-Mari Van der Westhuizen

12:43 - 12:51: OA-12-570-22-Characterising TB stigma in the community: a mixed methods study in Cambodia While biomedical approaches, such as case detection and treatment, have contributed substantially to the country's fight against tuberculosis (TB), other social determinants of health, such as stigma, are not well understood in Cambodia. This study aimed to characterise and explore the determinants of TB stigma among people with TB in Cambodia.  

Sovannary Tuot

12:51 - 12:59: OA-12-571-22-TB-related stigma in urban communities in Uganda: what are the predictors? In Ugandan urban communities, tuberculosis (TB) related stigma was higher among TB patients (65.6%) compared to non-TB patients (49.8%). The risk factors included having HIV-related stigma, being below 50 years of age and being a TB patient or a TB patient with low TB knowledge. Stigma reduction interventions should target these for greater impact.

Timothy Kiyemba

12:59 - 13:07: OA-12-572-22-Gender differences in perceived TB stigma in Kampala, Uganda: a cross- sectional analysis Tuberculosis (TB) is stigmatised in many high burden settings. Perceived stigma prevents individuals from engaging with TB diagnostic and treatment services. Men and women may differ in perceptions of, or sensitivity to, TB-related stigma. We conducted a cross-sectional study of perceived TB-related stigma to compare perceptions of TB stigma by gender.

Amanda J Meyer

13:07 - 13:15: OA-12-573-22-A mixed methods assessment of stigma in people living with drug-resistant TB and HIV in South Africa We characterise drug-resistant TB (DR-TB)/HIV stigma among co-infected patients in KwaZulu-Natal, South Africa, as part of the PRAXIS (Prospective Study of Adherence in M/XDR-TB Implementation Science) study. The drivers and manifestation of internal and enacted stigma attributable to DR-TB and HIV are elucidated, compared and linked, using mixed methods.

Amrita Daftary

13:15 - 13:23: OA-12-574-22-“I hope we can do infection control in a more human way.” Balancing safety and stigma in rural South African health facilities Tuberculosis infection prevention and control (IPC) measures, such as masks and patient separation, may be stigmatising to patients. It is also critical for preventing the spread of TB in health facilities. Developing messaging that clearly explains TB IPC, and which emphasises communal wellbeing and safety, could assist with addressing TB stigma.

Helene-Mari Van der Westhuizen

13:23 - 13:31: OA-12-575-22-Funding human rights programmes in the TB response: the Global Fund experience Stigma and discrimination are most frequently identified human rights barriers to accessing tuberculosis (TB) services. However, there is little understanding of programmes in order to address such barriers and how to integrate those programmes in TB response. The Global Fund is committed to supporting programmes to address access barriers and there will be discussion on the lessons learned.

Hyeyoung Lim

13:31 - 13:39: OA-12-576-22-The development and validation of a scale to measure stigma around, and in people with, drug-resistant TB This is a cross-sectional study, conducted in Viet Nam, which evaluated 45 stigma-related items in order to develop the first multidrug-resistant tuberculosis stigma scale. Exploratory factor analysis was used for item reduction and psychometric analysis was conducted to assess the validity of the remaining 14-item scale. 

Lisa Redwood

13:39 - 13:50: Q&A


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OA-14-COVID-19: the great disrupter
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OA-14-COVID-19: the great disrupter
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12:30 - 12:35: Introduction


12:35 - 12:43: OA-14-585-22-The contribution of asymptomatic SARS-CoV-2 infections to transmission: a model-based analysis of the Diamond Princess outbreak A key gap in the understanding of SARS-CoV-2 infection is the extent to which individuals, who are experiencing asymptomatic infections, contribute to transmission. We used a transmission model of COVID-19 to estimate the proportion, infectiousness and contribution to transmission of asymptomatic infections during the outbreak on the Diamond Princess cruise ship.

Jon C. Emery

12:43 - 12:51: OA-14-586-22-Effect of COVID-19 on TB patient notification in Japan To investigate the impact of COVID-19 spread on tuberculosis (TB) patients notification in Japan, we compared and analysed the numbers of newly notified TB cases in the first quarter of 2019 and 2020.

Kazuhiro Uchimura

12:51 - 12:59: OA-14-587-22-Contacts or care? Impact of COVID-19-related disruption on TB burden COVID-19-related disruptions could increase tuberculosis (TB) burden through negatively affecting health services and/or decrease transmission through reduced social contact. The impact on incidence may depend on the balance between these opposing factors. However, any benefit of distancing on the number of TB deaths, is likely to be outweighed by health service disruption.

Rebecca C. Harris

12:59 - 13:07: OA-14-588-22-The impact of the COVID-19 epidemic on active TB case finding interventions in Nigeria: the KNCV TB Foundation Nigeria experience The COVID-19 epidemic impacted negatively on the tuberculosis (TB) programme in Nigeria. Results from two core, active TB case finding interventions being implemented by KNCV TB Foundation Nigeria - the TB surge and WoW campaigns - showed a progressive decline in achievement from the onset of COVID-19 to date.  

Bethrand Odume

13:07 - 13:15: OA-14-589-22-Willingness to test for TB among symptomatic community members in an era of COVID-19: findings from an exploratory mixed methods study from Anambra State, Nigeria We explored the impact of the COVID-19 response on willingness to undergo a tuberculosis (TB) test at the community level. The language of communication of the COVID-19 interventions seemed to evoke fear among community members and negatively affected their willingness to do a TB test, despite having symptoms of TB. 

Chukwuebuka Ugwu

13:15 - 13:23: OA-14-590-22-Use of virtual and community-delivery platforms to prevent multidrug-resistant TB treatment interruption during the national COVID-19 response: lessons from Uganda COVID-19 came with unprecedented disruptions in the management of multidrug-resistant tuberculosis. This was particularly the case as a nationwide lockdown was announced, restricting community care of drug-resistant tuberculosis where over 80% of the patients are.

Enock Kizito

13:23 - 13:31: OA-14-591-22-Implementation of psychosocial support services for patients with TB during the quarantine regime due to COVID-19 In response to the emergency, the Ukraine national tuberculosis (TB) programme and the project quickly reformatted the implementation of services for patients with TB in order to ensure continuous access to anti-TB treatment and psychosocial support during the quarantine regime due to COVID-19.

Tanya Ismagilova

13:31 - 13:50: Q&A


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OA-13-The race for improved multidrug-resistant care
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OA-13-The race for improved multidrug-resistant care
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12:30 - 12:35: Introduction


12:35 - 12:43: OA-13-577-22-Best practices in bedaquiline and delamanid use for rifampicin- resistant TB management: implementation of extension and combination use in 43 high burden countries Results from the #StepUpforTB 2020 study show 69% of countries recommend the combination use of bedaquiline and delamanid, while only 40% allow routine extension of either drug.  While policy recommendations for the newer drugs have included younger ages, adoption of best practices in bedaquiline and delamanid for adults remains slow.

Tiziana Masini

12:43 - 12:51: OA-13-578-22-The decentralised drug-resistant TB programme in South Africa: from policy to implementation A policy, supporting decentralised drug-resistant TB (DR-TB) treatment provision in South Africa, has had variable implementation. This paper examined how content, actors and processes of policy have interacted in context-specific ways to inform implementation. A better understanding of policy dynamics will contribute to lessons for strengthening future implementation of DR-TB policy.

Waasila Jassat

12:51 - 12:59: OA-13-579-22-Programmatic management of MDR/XDR-TB patients using the short treatment regimen from 2015 to 2019 in Cameroon Cameroon's programmatic management of rifampicin-resistant and multidrug-resistant tuberculosis (TB) patients, from 2015-2019, showed an 82% (505 out of 706) favourable outcome using the short treatment regimen. Out of 478 (68%) patients with documented data, moderate to severe auditory side effects (57/12%) remain the major challenge. We advocate for closer audiogram monitoring of patients receiving an injectable-base regimen.

Christelle G. Jouego

12:59 - 13:07: OA-13-580-22-Outcomes of a representative sample of patients lost to follow-up during drug-resistant TB treatment in the Philippines We identified additional mortality after tracing drug-resistant tuberculosis (TB) patients lost to follow-up from the Philippines National TB Control Programme. Strategies for retaining patients in care are critical to improving outcomes. Tracing should be considered for reporting accurate mortality data.

Alexander Rupert Lim

13:07 - 13:15: OA-13-581-22-Undiagnosed drug resistance in Mycobacterium tuberculosis is associated with higher mortality in countries with high TB burdens Accurate diagnosis is important in managing and controlling drug-resistant tuberculosis (TB) to reduce mortality. We compared results from drug resistance diagnoses clinics in countries with high TB burdens, against standardised culture-based testing and whole genome sequencing.

Martina L. Reichmuth

13:15 - 13:23: OA-13-582-22-Predominant yield of drug-sensitive TB among contacts of multidrug- resistant TB patients in Uganda: a call for next generation sequencing Contact investigation is one of the key, active tuberculosis (TB) case finding measures for early detection and treatment initiation in order to mitigate transmission and mortality due to delayed treatment. This abstract demonstrates the findings of a contact tracing cascade analysis for multidrug-resistant TB patients in a low-resource setting.

Kenneth Mutesasira

13:23 - 13:31: OA-13-583-22-Achieving high treatment success rate for drug-resistant TB following introduction of the novel, shorter treatment regimen Uganda adopted the novel, shorter multidrug-resistant TB (MDR-TB) treatment regimen following the 2016 World Health Organization MDR-TB treatment guidelines update. We share findings of a high treatment success rate among patients enrolled into the shorter regimen. 

John Paul Otuba

13:31 - 13:39: OA-13-584-22-Introducing facility-based mortality reviews into programmatic management of drug-resistant TB: lessons from Uganda We share findings of patient and health system factors that are contributing to multidrug-resistant tuberculosis patient mortality, following the introduction of facility-based death reviews into the programmatic management of drug-resistant TB in Uganda. 

John Paul Otuba

13:39 - 13:50: Q&A


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OA-16-TB Xpert in low- and middle-income countries: ensuring quality and quantity
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OA-16-TB Xpert in low- and middle-income countries: ensuring quality and quantity
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12:30 - 12:35: Introduction


12:35 - 12:43: OA-16-598-22-Phased scale-up of external quality assurance for GeneXpert MTB/RIF testing under national TB elimination programme , India India's TB programme has rapidly scaled-up GeneXpert MTB/Rif testing, almost doubling the sites (628 to 1180), and testing has increased by five times (578173-2407211) from 2016 to 2018. To ensure a quality testing process, it strategically implemented External Quality Assurance (EQA) in a phased manner to monitor the quality of testing.

K Reena

12:43 - 12:51: OA-16-599-22-South Africa’s Xpert MTB/RIF Ultra external quality assurance experience: a need for good laboratory practice to minimise contamination South Africa's experience using external quality assurance in detecting contamination, due to Xpert® MTB/RIF Ultra’s increased sensitivity, and the need for improved good laboratory practice. A notable increase in the number of discordant results was analysed to advise on programme training needs and procedures to be reviewed for minimising contamination in routine settings.

Puleng Marokane

12:51 - 12:59: OA-16-600-22-Mentoring TB labs for improving and sustaining quality management system implementation and ISO 15189 accreditation: experiences from India The abstract focuses on experiences from India for improving and sustaining quality management system (QMS) implementation and ISO 15189 accreditation at 11 tuberculosis laboratories through mentoring support over the last three years

Tarak Shah

12:59 - 13:07: OA-16-601-22-A pilot study on the implementation of proficiency testing dried tube specimen production at a national public health laboratory: National Tuberculosis Laboratory, Kenya The external quality assurance panels enable facilities to identify diagnostic gas on time to enable continuity of quality services.
The Kenya National Tuberculosis Reference Laboratory demonstrated competency for panel production and managing the pilots, including corrective actions. These was made possible by mentorship from the US CDC, Atlanta, and the SRL, Uganda.

Solomon Bundi

13:07 - 13:15: OA-16-602-22-Role of GeneXpert technology in early detection of rifampicin-resistant TB in Afghanistan Elimination of tuberculosis (TB) is a major health priority for Afghanistan. Multidrug-resistant tuberculosis (MDR-TB) poses enormous challenges to health systems due to the complexity of diagnoses and treatment. For better diagnostic of presumptive MDR-TB patients, new bacteriologic-confirmed patients and extra-pulmonary TB, the national TB programme installed 49 GeneXpert machines.

Del Aqa Safi

13:15 - 13:23: OA-16-603-22-Overcoming barriers to GeneXpert optimisation in Nigeria: an analysis using the access concept GeneXpert optimisation is key to improving tuberculosis (TB) diagnosis, including rifampicin-resistant TB. However, Nigeria is yet to achieve the optimisation goal. This qualitative case-based study analyses barriers to effective GeneXpert optimisation using the ‘access concept’ and proposes proven health system and community strategies to surmount them.

Ogoamaka Chukwuogo

13:23 - 13:31: OA-16-604-22-The use of Xpert MTB/RIF in mobile vans: experience from Namibia A Namibian experience of using Xpert MTB/RIF instruments in mobile vans to demonstrate the feasiblility of use of these instruments in field-based screening activities. This demonstration proves that Gene X-pert can be utilised effectively outside routine laboratory settings to screen and diagnose drug-resistant tuberculosis (TB) in order to combat TB transmission.

Anita Beukes

13:31 - 13:50: Q&A


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OA-15-TB preventive therapy: we need to do better
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OA-15-TB preventive therapy: we need to do better
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12:30 - 12:35: Introduction


12:35 - 12:43: OA-15-592-22-Reaching at-risk groups with TB preventive therapy: building on commitments made at the United Nations High Level Meeting By September 2018, Uganda's tuberculosis preventive therapy (TPT) coverage was very low. Following high-level leadership and stakeholder engagement, procurement of commodities and the establishment of a strong accountability mechanism for TPT results, the country has surpassed its United Nations High-Level Meeting TPT enrollment target for people living with HIV, with a 90% completion rate. 

Stavia Turyahabwe

12:43 - 12:51: OA-15-594-22-Uptake of isoniazid preventive therapy among newly diagnosed people living with HIV initiating antiretroviral therapy in South Africa: a post-hoc analysis of a cluster randomised trial Fourteen clinics were randomised to standard of care or Quantiferon-gold in-tube test for diagnosis of TB infection in newly diagnosed people living with HIV in North West, South Africa. We present a post-hoc analysis of isoniazid preventive therapy uptake among participants who initiated antiretroviral treatment within 30 days of study enrolment.

Kate Shearer

12:51 - 12:59: OA-15-595-22-Systems approach to improve TB preventive therapy outcomes among people living with HIV in resource-limited settings: experiences from East-Central Uganda Tuberculosis preventive therapy outcomes have been suboptimal, especially in sub-Saharan Africa, due to a combination of health system and patient-level barriers. A health system approach to address logistical, health workforce, service delivery barriers and patient level- barriers, using the quality improvement methodology, is critical in ensuring good completion rates.

Rodrigo Nyinoburyo

12:59 - 13:07: OA-15-596-22-Increasing access to TB preventive treatment for children under-five in Democratic Republic of Congo: preliminary results We documented lessons learned from the implementation of household contact investigation of children 0-14 years old, in collaboration with a local civil society organisation, in 21 health facilities in Kinshasa, Democratic Republic of Congo (DRC)

VICKY ILUNGA

13:07 - 13:15: OA-15-597-22-Interferon-gamma cytokine concentration levels as a biomarker for recent infection with Mycobacterium tuberculosis in an African community setting Tuberculosis preventive therapy is prioritised for latently infected groups at high risk for active disease. In a cohort study design, we determined that concentrations of interferon-gamma could serve as a biomarker to discriminate individuals that are recently infected with Mycobacterium tuberculosis from remotely infected persons with similar TST reading.

Samuel Kirimunda

13:15 - 13:42: Q&A


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OA-17-Safety first: side effects of old and new drugs
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OA-17-Safety first: side effects of old and new drugs
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12:30 - 12:35: Introduction


12:35 - 12:43: OA-17-605-22-Audiometry outcomes during and after drug-resistant TB treatment with a kanamycin-containing drug-regimen: drug-resistant TB patients assessed in three rural districts of Masvingo Zimbabwe The abstract focuses on the ototoxic effects of a kanamycin-containing regimen on drug-resistant (DR-TB) patients managed in rural Zimbabwe without previous access to audiometry monitoring. Results show the importance of screening for drug side-effects during, as well as after, stopping the drug.

Cordelia Kunzekwenyika

12:43 - 12:51: OA-17-606-22-Validation study comparing tablet-based and conventional audiometry results in stage 2 of the STREAM trial Due to limited access to conventional audiometry testing in many high TB burden countries, tablet-based audiometry was used to monitor and evaluate for changes in hearing among multidrug-resistant tuberculosis trial participants. This validation study investigates the accuracy of tablet-based audiometry compared to conventional audiometry in stage 2 of the STREAM Trial.

Ishmael Qawiy

12:51 - 12:59: OA-17-607-22-Safety and efficacy of a shorter TB treatment: time to sputum culture positivity as a surrogate marker of bacterial load in an radomised control study of high-dose rifampicin and pyrazinamide Tuberculosis (TB) treatment is long, posing a risk of poor treatment adherence. In this randomised phase II study, we aim to investigate a strategy to shorten TB treatment by exploring safety, drug exposure and efficacy of a high-dose rifampicin/pyrazinamide regimen on early bactericidal activity using time to sputum culture positivity (TTP).

David Ekqvist

12:59 - 13:07: OA-17-608-22-Predictive analyses of QT prolongation from ECG monitoring in STREAM stage 1 The STREAM stage 1 trial investigated a short nine-month regimen for the treatment of multidrug-resistant tuberculosis, which included high-dose moxifloxacin and clofazimine, both of which can lead to QT prolongation. We analysed whether assessment of QT interval early on in treatment could be used to identify patients requiring more intensive QT monitoring.

Gareth Hughes

13:07 - 13:15: OA-17-609-22-A study to determine the frequency of QT interval prolongation in people treated with bedaquiline for drug-resistant TB Bedaquiline (BDQ) is a recent addition to the drug-resistant tuberculosis (DR-TB) armamentarium. There is a black-box warning of arrhythmias and sudden death associated with BDQ therapy. This retrospective study aimed to determine the incidence of QTc prolongation and cardiac events in patients receiving BDQ DR-TB therapy under routine conditions.

Sharon Isralls

13:15 - 13:23: OA-17-610-22-Pretomanid added to bedaquiline and linezolid for patients with extensively-drug resistant TB and multidrug-resistant TB treatment failure or intolerance: a comparison of prospective cohorts The Nix-TB study, evaluating the treatment of 109 patients with highly resistant TB with the oral 3-drug regimen (bedaquiline, pretomanid and linezolid; BPaL) for six-nine months, is compared to a cohort of contemporaneous patients, in South Africa, receiving regimens that included bedaquiline and linezolid, but not pretomanid.

Suzette Oelofse

13:23 - 13:31: OA-17-611-22-Moxifloxacin pharmacokinetics and cardiac safety in children with multidrug-resistant TB In this work, we characterise moxifloxacin pharmacokinetics and the exposure-response relationship with QT-interval prolongation in children 0-17 years. These results are from two observational pharmacokinetic and safety studies and provide important information regarding moxifloxacin use in young (<7 years) children and insight on optimal dosing.

Kendra K Radtke

13:31 - 13:50: Q&A


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SP-19-Household and close contact investigation: a key gateway to TB prevention and case detection in children
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SP-19-Household and close contact investigation: a key gateway to TB prevention and case detection in children
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Children exposed to tuberculosis (TB) are at high risk of becoming infected and developing active TB disease. The World Health Organization recommends household TB contact investigation as routine public health practice. Scale-up of this intervention will be key to reach the End TB strategy and United Nations High-Level Meeting targets for paediatric TB case finding and prevention. Nevertheless, implementation of contact investigation remains challenging in TB-endemic countries. This session will review recent evidence on the effectiveness of contact investigation and TB preventive treatment (TPT) in children and discuss implementation approaches adapted for delivery in high-burden settings, including early implementer experiences on the roll-out of shorter TPT regimens.

12:30 - 12:35: Introduction

12:35 - 12:47: Assessing the risk of TB in children after close exposure: implications for implementation of contact investigation interventions in high TB burden countriesGlobally, tens of millions of children are exposed to an individual with tuberculosis (TB) annually. Drawing upon a multicohort collaboration of research groups, we aimed to explore two questions: i) estimating the risk of developing TB by time-period of follow-up, demographics (age, region), and clinical attributes (HIV, TB infection status, previous TB); and ii.) estimating the effectiveness of preventive therapy and BCG vaccination on the risk of developing TB. The results of this work will be presented in this session showing that the risk of developing TB among exposed infants and young children is very high and that most cases occurred within weeks of contact investigation initiation and might not be preventable through prophylaxis. Taken together, these findings suggest that alternative strategies for prevention are needed, such as earlier initiation of preventive therapy through rapid diagnosis of adult cases or community-wide screening approaches.
Leonardo Martinez

12:47 - 12:59: Implementation of contact investigation and TB preventive therapy provision in NepalBefore 2017, the Nepal national TB programme (NTP) mainly focused on passive case finding with limited active case finding activities. Contact tracing was implemented by the NTP in 38 high TB burden districts since early 2017. All household contacts undergo symptom screening and those screening positive are referred for tuberculosis (TB) evaluation, while children <5 without symptoms are referred for TB preventive therapy (TPT). Contact tracing of 27,982 bacteriologically-confirmed TB cases was done between March 2018 and December 2019.  There were 3,735 children initiated in TPT, with 96.8% retained in treatment (completing or still on treatment) and 3.2% discontinuing. Results have shown that contact tracing and a strong care cascade for TPT can be achieved in a low-resource setting, with an apparent immediate impact on TB outcomes. Programmes will be scaled-up throughout Nepal, through provision of adequate budget from both government and donors, maintaining routine supervision to ensure adherence and completion of TPT.
Suvesh Kumar Shrestha

12:59 - 13:11: Implementing household contact investigation in high TB burden, resource-limited settings: lessons learned from a multicountry project in nine sub-Saharan countriesContact investigation is recognised as an important intervention and it serves as a key entry point for both paediatric tuberculosis (TB) case finding and prevention. However, roll out and scale-up of contact investigation interventions remain challenging in high TB burden countries. The CaP TB project has implemented contact investigation interventions across nine sub-Saharan African countries and evaluated the cascade of care for both TB detection and TB preventive treatment. This presentation will review the evidence generated so far by the project, including early experiences on the use of the 3RH regimen under routine conditions, and discuss practical lessons learned on strategies and approaches that can improve implementation of contact investigation.
Martina Casenghi

13:11 - 13:23: Moving to shorter regimens for TB preventive treatment in children: current and future opportunitiesTuberculosis (TB) is a top cause of paediatric TB morbidity and mortality. Identifying recently exposed children and initiating TB preventive treatment (TPT) has been a longstanding approach to TB control. Short-course TPT has recently been endorsed by the World Health Organization and is an attractive solution to improving uptake and completion rates. There are many considerations for countries as they roll out short-course TPT for household child contacts and children and adolescents living with HIV. We will describe the current landscape for short-course TPT in both of these populations and highlight the gaps in our knowledge as they relate to paediatric dosing, drug interactions and efficacy. We will conclude with timelines for paediatric formulations for rifapentine and current research into 1HP and other novel short-course regimens.
Nicole Salazar-Austin

13:23 - 13:50: Q&A session

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P2-COVID-19: Major disrupter, new opportunities
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P2-COVID-19: Major disrupter, new opportunities
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With over 36 million cases and 1 million deaths in early October, the COVID-19 pandemic, caused by the novel corona virus SARSCoV-2, brought the world to a halt in early 2020. Cities and countries retreated into varying degrees of social lockdown, economies plummeted and the medical and scientific fraternities scrambled to prepare and to uncover treatments and prevention strategies. How might we have been better prepared? What can we learn from our responses? And how can we use this opportunity to address historical inequalities that have been thrown into relief during this time?

14:00 - 14:03: Session introduction


14:03 - 14:18: PL2A-Lessons from the past and present for future pandemics

Michael T. Osterholm

14:18 - 14:23: PL2B-Global response to COVID-19

Maria Van Kerkhove

14:23 - 14:33: Impact of COVID pandemic on health care priorities and programmes

Madhukar Pai

14:33 - 14:48: PL2C-Human rights issues exposed

Allan Maleche

14:48 - 14:58: PL2D-Moderated panel discussion

Michael T. Osterholm
Madhukar Pai
Allan Maleche

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OA-20-The Union late-breaker session on COVID-19
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OA-20-The Union late-breaker session on COVID-19
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15:00 - 15:05: Introduction


15:05 - 15:13: LB-2100-22-Comparative evaluation of the clinical accuracy of SARS-CoV-2 serological rapid diagnostic tests and manual ELISAs The clinical accuracy of 25 commercially available SARS-CoV-2 antibody tests in five countries - Brazil, Italy, Spain, Switzerland and the USA - was determined. Our results suggest that the majority of antibody rapid diagnostic tests (RDT's) have insufficient sensitivity and specificity, but there are several high performing lab-based ELISAs that meet World Health Organization target product profile targets.

Jilian Sacks

15:13 - 15:21: LB-2093-22-Clinical accuracy, ease of use and limit of detection of SARS-CoV-2 antigen-detection rapid diagnostic tests The clinical performance, limit of detection and ease of use of six commercially available SARS-CoV-2 antigen rapid diagnostic tests was assessed in three countries - Brazil, the UK and Germany. Though there is substantial performance variability, our results suggest that at least two meet a minimum of 70% clinical sensitivity and 97% clinical specificity.

Jilian Sacks

15:21 - 15:29: LB-2090-22-High mortality among persons with comorbid rifampicin-resistant TB and COVID-19 in Khayelitsha, South Africa In April 2020, there were 181 active rifampicin-resistant tuberculosis (RR-TB) patients; 46 (25%) were tested for COVID-19 (n=22[48%] newly diagnosed) and 17 (37%) tested COVID-19 positive. Among those co-infected, eight (47%) died. Few newly diagnosed RR-TB patients were investigated for COVID-19 suggesting missed opportunities to detect COVID-19. Additionally, the mortality was high.

Erika Mohr-Holland

15:29 - 15:37: LB-2122-22-TB and COVID-19 co-infection among people with cough screened during active case finding of COVID-19 in the community with a high prevalence of TB This study shows the experience of screening for both tuberculosis and COVID-19 at the same time, using Xpert MTB/Rif and SARV-CoV-2 PCR tests, in the north of Lima during the programmatic activities on COVID-19 response in Peru.

Marco Tovar

15:37 - 15:45: LB-2113-22-Automated detection of COVID-19 in chest X-rays using deep learning for instant triage in hospital settings and integration with structured report generation Artificial intelligence screening of chest X-rays for COVID-19, integrating with structured reporting tools, can be an excellent tool for hospital triage to streamline workflows and hasten report turnaround time. It can act as a valuable auxiliary method for pre-screening symptomatic suspects and for providing final diagnostic reports with imaging, keeping experts in the loop.

Amit Kharat

15:45 - 15:53: LB-2051-22-Potential impact of the COVID-19 pandemic on essential TB services in Sri Lanka Common respiratory origin and interference with host immunity results in many clinical similarities between tuberculosis (TB) and COVID-19. Due to COVID-19, the Sri Lankan healthcare system is stretched beyond capacity. The catastrophic effect of COVID-19 on normality of the population and healthcare services has a negative impact on TB case detection.

Chathurani Mekala Wickramaarachchi

15:53 - 16:20: Q&A


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OA-19-Histories of success: improving TB and latent TB infection care
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OA-19-Histories of success: improving TB and latent TB infection care
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15:00 - 15:05: Introduction


15:05 - 15:13: OA-19-619-22-Utility of stool CBNAAT in the diagnosis of paediatric pulmonary TB in India This study was conducted in New Delhi, India. It evaluated the utility of the stool CBNAAT test in paediatric pulmonary tuberculosis (TB). Results of stool CBNAAT were in near perfect agreement with Gastric aspirate CBNAAT results. This specimen could help in achieving microbiological confirmation in peripheral areas with a shortage of trained staff.

Anurag Agarwal

15:13 - 15:21: OA-19-620-22-Improving TB treatment outcomes: the role of the quality improvement approach: a case from Nairobi City County, Kenya Quality improvement (QI) plays a critical role towards attainment of the End TB Strategy goals, leveraging on already existing systems. This intervention demonstrates sustainable team-driven strategies that adopt a QI approach towards improvement of tuberculosis (TB) outcomes in the highest TB-burden county of Kenya.

Evelyn Nganga

15:21 - 15:29: OA-19-622-22-Use of intravenous isoniazid and ethambutol administration in patients with new sputum-positive, drug-susceptible pulmonary TB with tuberculous meningoencephalitis and HIV co-infection Fifty-four patients with TB-meningoencephalitis (TM) and HIV co-infection, were enrolled in this study. In TB-TM with HIV, intravenous isoniazid and ethambutol treatment was more effective than oral isoniazid and ethambutol at two months of intensive treatment. In addition, the mortality rate was lower in intravenously isoniazid and ethambutol treatment than oral.

Dmytro Butov

15:29 - 15:37: OA-19-623-22-When facility-based detection is not enough: increasing TB case detection through a social and behaviour change strategy in Nigeria The United States Agency for International Development's SHOPS Plus project created a social and behaviour change strategy, using geographic information systems (GIS) data, to hold community-led events in high tuberculosis (TB) burden communities where local healthcare providers and community leaders educate community members to seek care for TB symptoms and offer free TB screening and testing.

Ayodele Iroko

15:37 - 15:45: OA-19-624-22-Treatment uptake in people with TB detected by active case finding in Cà Mau Province, Viet Nam In the context of community-wide screening in rural province Cà Mau, Viet Nam, we estimate the proportion of tuberculosis screen-positive individuals who participate in each stage of the treatment cascade.

Boi Khanh Luu

15:45 - 15:53: OA-19-625-22-Analysis of large, patient-level dataset to predict outcome of treatment for patients with drug-sensitive and drug-resistant TB Drug-resistant tuberculosis (DR-TB) treatment is challenging and frequently leads to poor outcomes. NIAID TB Portals programme - an international collaboration focusing on DR-TB - collects, annotates and analyses patient-level data from multiple hospitals. We present a comprehensive machine learning analysis of patient characteristics, across diverse domains, associated with treatment outcome.

Qinlu Wang

15:53 - 16:20: Q&A


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Community Connect
Finding missing people with TB: what it will take to achieve the UN HLM targets
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Finding missing people with TB: what it will take to achieve the UN HLM targets
At the United Nations High-Level Meeting on Tuberculosis (UNHLM on TB) in September 2018, member states committed to finding, diagnosing, and treating 40 million people with TB between 2018 and 2022. According to the 2019 Global TB report, an estimated 10 million people fell ill with TB in 2018 and 7 million people were reached with TB care in 2018, up from 6.4 million in 2017. Nearly 75% of the 3 million ‘missing people with TB’ were estimated to be accessing care in the private sector. While this was a major milestone towards delivering on the political declaration on TB, progress has been severely derailed by the COVID-19 pandemic. Nearly all recent studies show sharp drop in TB notification globally, up to 70%. Most countries report that active case-finding has been completely halted and the focus during the pandemic has been on ensuring continuity of services for TB patients. However, without finding these missing people with TB, it is virtually impossible to achieve the HLM targets. Against this backdrop, this session will explore the challenges, opportunities and approaches, including new innovations for reaching the missing people with TB in the changed landscape. 

1. Dr Suvanand Sahu, Deputy Executive Director - Stop TB Partnership Secretariat
2. Dr Andy Eyo, Chief Executive Officer/Project Director - ECEWS UNOPS/TB REACH
3. Blessi Kumar, CEO - Global Coalition of TB Activists
4. Rachel Forse - Friends for International TB Relief (FIT)
5. Amir Khan, Epidemiologist and Social Entrepreneur - Interactive Research and Development (IRD)
6. Aaron Oxley, Executive Director - RESULTS UK
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SP-21-Engaging communities to address concurrent pandemics of TB and COVID-19
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SP-21-Engaging communities to address concurrent pandemics of TB and COVID-19
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This symposium will utilise a range of perspectives to explore the critical role of community engagement to address tuberculosis (TB) and COVID-19. We will hear front line field notes from a community health worker (CHW) in South Africa. We will learn from experiences of applying knowledge from TB to deliver testing and contact tracing for COVID-19 through non-profit organisations in Peru and the U.S. We will examine strategies for engaging with policy makers to support CHWs and reduce the dual stigma of these infections. Finally, we will discuss partnerships with the media to maximise the impact of public health messaging to communities.

15:00 - 15:05: Introduction

15:05 - 15:15: Field notes: a frontline community health worker perspective on responding to TB in the time of COVID-19Community health workers (CHWs) play a critical role in supporting person-centred care, raising tuberculosis (TB) awareness, providing TB information in local languages to communities, and reaching missing people with TB who are not accessing health services and linking them to the health system. Each person has a human right to health and CHWs play a critical role in transforming the TB response to be equitable, rights-based and people-centred. Yet, CHWs are not provided with platforms to inform the TB response despite being experts on the healthcare needs of communities. Ms. Muedi will discuss insights from frontline CHWs, including identified gaps in the training and personal protective equipment offered to CHWs caring for people with TB, and the role of CHWs in the response to COVID-19.  
Portia Muedi

15:15 - 15:25: Prioritising partnerships: mobilising community health workers to fight COVID-19 in PeruSocios En Salud (SES) has partnered with the United States Agency for International Development to support Peru’s healthcare system to care for patients with COVID-19. Dr. Lecca will discuss how SES activated a community health worker network to safely conduct outreach visits to identify families needing clinical and social support in Peru’s hardest hit regions of Lima as well as a medical call centre to conduct telehealth consultations. Dr. Lecca will discuss how SES applied its many years of experience mobilising CHWs to contact public health education and contact tracing for TB in order to train CHWs to safely provide community-based care and education.  
Leonid Lecca

15:25 - 15:35: Bending the curve: leveraging experiences from TB care to contain COVID-19 in MassachusettsPartners In Health (PIH) is a non-governmental organisation that has built long standing relationships with ministries of health and communities in the world’s poorest settings, with the goal of providing the highest standard of care to all. As such, they are well positioned to tackle COVID-19, which is having a disproportionate impact on communities already affected by poverty and poor healthcare. Dr. Seung will discuss how PIH developed an ambitious response that sought to bend, rather than merely flatten, the curve of COVID-19 in Massachusetts and other U.S. states by applying lessons learned from TB with respect to testing, contact tracing, and supported quarantine and isolation. He will discuss the challenges of implementing rapid testing and addressing the social and economic needs of underserved communities, including the use of food and cash assistance, as part of a comprehensive response.
KJ Seung

15:35 - 15:45: Engaging policy makers to protect community health workersMs. Schoeman will discuss insights gained from leading a Gates Foundation funded project to empower community health workers (CHWs) to motivate for and contribute to person-centred tuberculosis (TB) care, by providing training in advocacy, media and communications. In response to stigma being identified as a major barrier in the TB care cascade, she helped to facilitate CHWs in Hammanskraal, Gauteng province, to develop community-focused theatre plays to address stigma.  She will discuss the challenges of building and maintaining strong relationships locally, provincially and nationally in order to secure support for in-service TB training of CHWs and for an implementation plan to accompany the Ward Based Primary Health Care Outreach Team policy that was recently released by the department of health. Finally, she will examine how TB Proof was able to leverage its TB advocacy partnerships to advocate to the South African government to impose a lockdown and #Masks4All policy to disrupt COVID-19 transmission.

Ingrid Schoeman

15:45 - 15:55: Partnering with the media to deliver public health messages to communitiesGovernments in high tuberculosis (TB) incidence settings like India have consistently failed to invest adequately in health and ensure funding of basic programmes to test, trace and treat TB. Concurrently, stigma and mistrust of government health systems have fuelled longstanding challenges to engage communities to participate in TB screening and to complete treatment. The COVID-19 pandemic has exacerbated social inequities with lockdowns and mass unemployment that have a disproportionate effect on the poorest, particularly while investment in testing, tracing and isolation remains inadequate. Ms. Krishnan will discuss insights she has gained from interviews with people affected by TB and other key stakeholders in the context of the COVID-19 pandemic. She will provide suggestions as to how public health professionals can engage communities with more effective messaging and interventions that are responsive to their needs. She will also address perceived gaps in current TB advocacy, from her unique perspective as a journalist.
Vidya Krishnan

15:55 - 16:20: Q&A session

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TBS2A-TB infection and disease - the details: plenary session
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TBS2A-TB infection and disease - the details: plenary session
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Recent research has suggested that M. tuberculosis can present as more subtle states than just 'latent' infection and active disease. This has relevant diagnostic, preventive, therapeutic, transmission, modelling and economic analyses implications. This session is intended to discuss different implications of the spectrum of tuberculosis infection.

15:00 - 15:03: Introductory note


15:03 - 15:23: Subclinical TB in epidemiological models: What we know, what we don't, and what difference it makes

Emily Kendall

15:23 - 15:43: Bacterial and host determinants of cough aerosol culture-positivity in patients with drug-resistant or drug-susceptible TB

Grant Theron

15:43 - 16:03: Natural history of subclinical tuberculosis tracked by PET/CT and blood biomarkers

Anna Coussens

16:03 - 16:22: Live Q&A


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SS2-COVID-19: different strokes
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SS2-COVID-19: different strokes
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While SARS-CoV2 has spread across the world, countries’ responses have varied around the globe. This session will focus on the different approaches and the impact of these strategies on country statistics and experiences. The discussion will include the reasons for different strategies (including lessons learned from other epidemics), the pros and cons of these approaches and the possible translational lessons for tackling other epidemics.

15:00 - 15:03: Introduction


15:03 - 15:13: Turkey: targeted mitigation

Kayihan Pala

15:13 - 15:23: Senegal: be prepared

Abdoulaye Bousso

15:23 - 15:33: South Africa: Early lockdown

Glenda Gray

15:33 - 15:43: Brazil: Missed opportunities

Guilherme Werneck

15:43 - 15:53: New Zealand: Elimination strategy

Ayesha Verrall

15:53 - 16:03: Australia: Adaptability

Jodie McVernon

16:03 - 16:13: A personal experience

Robin Gorna

16:13 - 16:28: Live Q&A and moderated discussion

Kayihan Pala
Abdoulaye Bousso
Glenda Gray
Guilherme Werneck
Jodie McVernon
Robin Gorna

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OA-18-(Im)possible mission: TB care in low-resourced settings
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OA-18-(Im)possible mission: TB care in low-resourced settings
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15:00 - 15:05: Introduction


15:05 - 15:13: OA-18-612-22-Enabling MPs to support and take ownership of India’s TB programme Localised review and troubleshooting mechanisms, with political will and ownership driving them forward, could be pivotal for the success of tuberculosis (TB) programmes. This pilot initiative showed that elected representatives (Members of Parliament), when provided with the right tools and information, are well placed to support TB elimination efforts. 

Indira Behara

15:13 - 15:21: OA-18-613-22-99DOTS for TB treatment supervision in Uganda: adherence rates and acceptability 99DOTS is a low-cost technology with the potential to improve tuberculosis (TB) treatment adherence and completion. We implemented 99DOTS at 18 health facilities in Uganda to evaluate treatment adherence, benefits and challenges of using it. Despite challenges of phone availability and software malfunctions, patients and providers found the technology acceptable and convenient.

Alex Kityamuwesi

15:21 - 15:29: OA-18-614-22-Determinants of delayed diagnosis and treatment of TB in high burden countries: a mixed methods systematic review and meta-analysis Delays in diagnosis and treatment vary across countries and little is known among countries bearing most of the global tuberculosis (TB) burden. Therefore, a systematic review and meta-analysis were undertaken to derive the determinants and duration of diagnosis and treatment delay of pulmonary TB in the high TB-burden countries.

Alvin Kuo Jing Teo

15:29 - 15:37: OA-18-615-22-The effect of depression, anxiety and other risk factors on adherence to anti-TB treatment in the Philippines It is important to know the effect of depression, anxiety, stigma, social/family support and nutrition on adherence. In the Philippines, there is limited published research on the barriers to adherence in tuberculosis (TB) patients. This study investigated the reasons for non-adherence among Filipino TB patients enrolled in public TB-DOTS centres. 

Hend Elsayed

15:37 - 15:45: OA-18-616-22-Impact of HIV 'test and treat' policy on the incidence of TB in HIV populations in East-Central Uganda This abstract demonstrates the impact of the test and treat early antiretroviral treatment initiation policy on the incidence of tuberculosis (TB) among HIV populations, in programme settings in sub-Saharan Africa. The risk of TB among people living with HIV significantly reduced with the test and treat policy. It adds programmatic evidence for the implementation of the policy.

Rodrigo Nyinoburyo

15:45 - 15:53: OA-18-617-22-Utility and benefits of TB molecular bacterial load assay to monitor TB therapy in a resource-limited, high burden setting Rapid and accurate tests are needed for monitoring tuberculosis (TB) therapy. We explored the utility and benefits of TB molecular bacterial load assay (TB-MBLA) for monitoring TB therapy. We found that the TB-MBLA test provides rapid and accurate results in time to inform clinical management of TB patients and that it can be applied in high burden settings.

Bariki Mtafya

15:53 - 16:01: OA-18-618-22-Using TB care process mapping to improve treatment retention and treatment success rate in low-income settings: experience from central Uganda According to the World Health Organization, tuberculosis (TB) treatment success rate (TSR) is below the 95% global target in many countries, including in Uganda. TB patient retention is a contributor to TSR. By early 2019, only 17% facilities were meeting the national retention target. A TB care process mapping intervention was implemented with improvements in retention and TSR.  

Herbert Kisamba

16:01 - 16:20: Q&A


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Channel 4
SP-20-Improving access to laboratory-based diagnosis for young children: recent advances using stool and urine as alternative sample types
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query_builder 15:00 - 16:20 | Event time (GMT+2)
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place Online Session/Virtual
card_travel Symposium
mic English
SP-20-Improving access to laboratory-based diagnosis for young children: recent advances using stool and urine as alternative sample types
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While clinical diagnosis remains valuable, improving access to laboratory-based diagnosis for children with presumptive tuberculosis (TB) is critical to increase diagnostic certainty and ensure timely initiation on effective treatment, even more so in settings with high transmission of drug-resistant TB. Laboratory-based diagnosis in children is hampered by challenges in obtaining adequate specimens and sub-optimal performance of existing tests on pauci-bacillary specimens. Recently the World Health Organization recommended stool as a useful specimen to diagnose pulmonary paediatric TB and urine-based LF-LAM for children living with HIV. This session will review the latest evidence on the role of those alternative sample types for childhood TB.  

15:00 - 15:05: Introduction

15:05 - 15:15: Closing the case detection gap in children with TB: WHO updatesOver 1.1 million children (aged under 15 years) were estimated to have fallen ill with tuberculosis (TB) in 2018 and over 200,000 of them died, the majority before their 5th birthday. The case detection gap was estimated at 54% and was highest (63%) in children under five, due to -among others - the paucibacillary nature of TB, the lack of a sensitive point-of-care test and the challenges in collecting a respiratory sample for bacteriological testing in young children. This presentation will set the scene covering the latest epidemiological data on TB children as well as progress towards the United Nations High-Level Meeting on TB targets for children. Updated World Health Organization policy recommendations, relevant to the diagnosis and management of TB in children, will be discussed.
Sabine Verkuijl

15:15 - 15:25: Utility of stool samples for microbiological confirmation of TB in childrenIn January 2020 the World Health Organization published a Rapid Communication on the use of molecular assays as initial tests for the diagnosis of tuberculosis (TB). The conclusions support the continued use of Xpert MTB/RIF and Xpert Ultra in children including stool samples. 
Following up on last year’s symposium, two parallel evaluations of centrifuge-free stool processing methods are underway, including the Stool Processing Kit (FIND), Simple One-Step (KNCV) and Sucrose Flotation (TB-Speed) methods, in combination with Xpert Ultra. 
The head-to-head comparison includes an assessment of the performance for TB detection as well as the ease of use of the three methods.
Pamela Nabeta

15:25 - 15:35: Update on simple one step stool testing method and practical guidance on the best placement of this test in the diagnostic algorithmTo assess the accuracy, feasibility and acceptability of the KNCV SOS stool method as compared to Xpert on a gastric aspirate or an induced sputum specimen, the SOS stool method is being implemented in parallel to the routine algorithm in Ethiopia and Indonesia. This will provide more precise accuracy estimates and valuable lessons for scale-up. Modelling studies are underway to provide more insights into the best placement of the method in the diagnostic algorithms. This presentation will outline key lessons learned to be addressed for scale-up of stool processing in countries and provide insights on how it can best be placed in the diagnostic algorithm for childhood tuberculosis.
Edine Tiemersma

15:35 - 15:45: Accuracy of a novel urine test, Fujifilm SILVAMP TB LAM, for the diagnosis of pulmonary TB in childrenAn accurate point-of-care test for tuberculosis (TB) in children remains an elusive goal. A novel urinary lipoarabinomannan (LAM) test, Fujifilm SILVAMP TB LAM (FujiLAM) showed superior sensitivity to Alere Determine TB LAM (AlereLAM) in HIV-infected adults. We compared the accuracy of FujiLAM and AlereLAM in children with suspected pulmonary TB presenting to hospital in Cape Town, South Africa. There were 204 children enrolled who had valid results from index and sputum tests. Using a microbiological reference standard, sensitivities of FujiLAM and AlereLAM were similar (42% and 50% respectively), but lower than Xpert MTB/RIF of sputum (74%).   However, specificity of FujiLAM was substantially higher than AlereLAM (92% vs. 66%), suggesting that non-specific detection accounted for the apparent higher sensitivity of AlereLAM. Sensitivity of FujiLAM was higher in HIV-infected and malnourished children. The high specificity of FujiLAM suggests utility as a ‘rule-in’ test for TB in children, particularly those who are HIV-infected.
Mark Nicol

15:45 - 15:55: Keynote : overview of where we are in childhood TB diagnosisThis presentation will discuss the role of the  sample types and tests recently recommended for tuberculosis (TB) diagnosis in the context of clinical and programmatic management of childhood TB and summarise remaining challenges to be addressed to close the gap in paediatric TB case finding
Ben Marais

15:55 - 16:20: Q&A session

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Channel 3
SP-23-Preventing TB in people with diabetes mellitus: where are we now and where are we going?
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query_builder 16:30 - 17:50 | Event time (GMT+2)
query_builder - | Your time (GMT)
place Online Session/Virtual
card_travel Symposium
mic English