19 October-1 December 2020
The 51st Union World Conference On Lung Health
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Channel 5
SP-45-Modelling to advance prevention
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SP-45-Modelling to advance prevention
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There is an urgent need to combine robust scientific evidence and leadership to identify cost-effective strategies and actions to advance the prevention of tuberculosis (TB). Mathematical modelling is a critical tool to create evidence on the potential health impacts, cost-effectiveness and resource implications of future TB prevention options. In this session we present new results on four key modelling initiatives focused on advancing prevention plus an activist's perspective on the importance of modelling prevention interventions for country and global-level TB decision making.

12:30 - 12:35: Introduction

12:35 - 12:45: Optimising investments in Mozambique’s TB responseMozambique is one of the 30 highest TB burden countries in the world. To achieve the goal of ending TB by 2035, it is crucial to determine which models of TB care and prevention should be prioritized. This is especially important in the context of limited resources, where options to prevent future TB cases may often be overlooked. We used Optima TB, a mathematical model of TB transmission and disease progression, integrated with an economic and programme analysis framework, to consider different policy options. We determined that Mozambique is not on track to meet the 2035 End-TB targets, and more funding for the TB program is required to reach strategic TB targets.
Pereira Zindoga

12:45 - 12:55: The epidemiologic impact and cost-effectiveness of new TB vaccines on multidrug-resistant TB in China and IndiaDespite recent advances through the development pipeline, how novel tuberculosis (TB) vaccines might affect multidrug-resistant TB (MDR-TB) is unknown. We investigated the epidemiologic impact, cost-effectiveness and budget impact of hypothetical novel prophylactic prevention of disease TB vaccines on MDR-TB in China and India. We constructed a dynamic model of TB, introducing novel vaccines from 2027 with post- (PSI) or both pre- and post- infection (P&PI) effectiveness, conferring 10 years of protection, with 50% efficacy. By 2050, the P&PI vaccine reduced rifampicin-resistant (RR-TB) and MDR-TB incidence rate by 70% and 68%, and the PSI vaccine by 29% and 38% in China and India. Our model predicted that a US$10 P&PI vaccine would be cost-effective at the GDP and healthcare opportunity cost threshold, and PSI vaccine cost-effective at the GDP threshold, in both China and India. TB vaccination will likely contribute to MDR-TB control and may be cost-effective but depends on vaccine characteristics and setting.
Chathika Weerasuriya

12:55 - 13:05: Risk-benefit analysis of TB infection testing for household contact management in high burden countriesHigh tuberculosis (TB) burden countries, expanding preventive therapy (PT) use, must decide how TB infection testing should be used for risk stratification among household contacts of TB patients. We modelled the risk of TB disease and risk of severe adverse events, comparing two PT strategies: PT for all household contacts, or PT for only household contacts with a positive tuberculin skin test. We used data from clinical trials and literature on TB natural history to model outcomes assuming different PT regimens, ages and tuberculin skin test positivity prevalences. Our findings suggest that, in high burden settings, giving PT to all contacts <18 years old would lead to substantially more protection with minimal additional adverse events compared to giving PT to only those with confirmed infection. For older contacts, adverse events are more of a concern; these can be minimised by using a rifampicin-only regimen and focusing PT on those with a positive infection test.
Courtney Yuen

13:05 - 13:15: Cost-effectiveness of interventions to scale-up short course TB preventive therapy among children in 12 countriesWe assessed the cost-effectiveness of household contact investigation for children under 5 years old across 12 high TB burden countries. We compared three scenarios: (a) status quo, (b) contact investigation with treatment of active tuberculosis (TB) only, and (c) contact investigation with treatment of active TB and provision of short course preventive therapy (3HP) for latent TB infection. We used data from the literature and a large 12-country implementation study to estimate country-specific incremental cost-effectiveness ratios. We projected that contact investigation with treatment of active TB and provision of preventive therapy is highly cost-effective compared to TB treatment only ($111 per disability-adjusted life year [DALY] averted) or status quo ($353 per DALY averted). Key drivers of cost-effectiveness were TB prevalence among contacts and case fatality of untreated TB. Screening child contacts for active TB and provision of short course treatment for latent TB infection can be cost-effective in high burden settings.
Youngji Jo

13:15 - 13:25: Modelling to advance prevention: a patient advocate's perspectiveCOVID-19 has wrenched the world’s attention back to the importance and value of infectious disease modelling. In South Africa such models were crucial in informing what has been hailed by the World Health Organization as a world-leading preventive approach to this pandemic. As a public health doctor and activist I have been delighted, but as a tuberculosis (TB) activist living with latent multidrug-resistant TB the contrast could not be more stark. TB remains the leading cause of death in South Africa, yet our approach has been focused far too much on reactive treatment, with a lack of evidence frequently cited as an excuse for token investments in prevention. Health workers were already dying from TB contagion in unacceptable numbers long before SARS-CoV-2 reminded us what happens if we fail to care for our carers. Modelling can help with these complex challenges – we must never again allow any infectious diseases to spread unchecked among us.
Arne von Delft

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

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Channel 4
SP-44-Self-clearance of Mycobacterium tuberculosis infection: needs and consequences
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SP-44-Self-clearance of Mycobacterium tuberculosis infection: needs and consequences
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While there is growing acknowledgement that a Mycobacterium tuberculosis (M.tb) infection is not lifelong, the consequences for tuberculosis (TB) epidemiology and prevention efforts remain unclear. In this symposium we describe how self-clearance affects the TB prevention of progression through the denominator, that is how many people carry a viable infection as well as the numerator, and does this change how many episodes of TB should we expect from distal M.tb infections? In addition, presenters will cover the need for, and progress towards, testing for self-clearance, as well as the impact on TB vaccine research and preventive therapy programmes.

12:30 - 12:35: Introduction

12:35 - 12:45: Self-clearance and the denominator: who is still at risk and what does that mean?The presentation will provide definitions around self-clearance of M. tuberculosis (M.tb) infection and distal progression to disease, and summarise historical and current evidence for self-clearance. Using those observations, the consequences for the reservoir of viable M.tb infections will be discussed, both in likely overall size and distribution across countries and age groups. Finally, the implications of this change in the denominator i.e. the population at risk of distal progression, will be discussed.
Rein Houben

12:45 - 12:55: Self-clearance and the numerator: evidence for disease from distal M. tuberculosis infectionsThe presentation will evaluate the evidence for disease from a distal M. tuberculosis infection, which has been a source for debate in recent years. Empirical and modelling evidence will be considered.
Katie Dale

12:55 - 13:05: Testing for self-clearance: needs and progressOur understanding of M. tuberculosis (M.tb) self-clearance is greatly limited by our current diagnostic tests, which cannot distinguish between those with ongoing viable M.tb infection, and those who have cleared it but remain immunologically sensitised to M.tb. This presentation will consider the limitations of current tests for M.tb infection and discuss the need, potential applications and impact of a test of M.tb clearance. Novel approaches, including transcriptomics, for evaluating M.tb clearance will be presented.
Claire Broderick

13:05 - 13:15: TB vaccines and self-clearance: consequences for development and researchIf M.tuberculosis (M.tb) infection is not lifelong, this has consequences for how TB natural history of M.tb infection is conceptualised.
One immediate question is how self-clearance might affect natural protection against reinfection, and what this might mean for the potential impact of new TB vaccines. In this session I will discuss this issue and what it might mean for TB vaccine development.
Richard White

13:15 - 13:25: Preventive therapy and self-clearance: consequences for current and future programmesIt is widely recognised that if tuberculosis (TB) is to be ended by 2050, disease arising from the reservoir of existing M.tuberculosis infections needs to be addressed, potentially through some future programme of mass preventive therapy. Current preventive therapy programmes focus on established high risk groups and have struggled to expand and retain individuals entering the preventive therapy care pathway. This presentation will focus on whether, and how, current or future preventive therapies programmes should be adjusted in light of the possibility of a large proportion of previously infected individuals self-clearing.
Dick Menzies

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

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Channel 1
OA-36-The role of pharmacies in the TB cascade of care
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OA-36-The role of pharmacies in the TB cascade of care
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12:30 - 12:35: Introduction


12:35 - 12:43: OA-36-721-24-Improving TB case finding through pharmacies using digital tools in Manila City, Philippines Programmatic implementation demonstrating the path of how pharmacy professionals in the community contribute to tuberculosis (TB) case finding through an e-referral tool in the SwipeRx mobile app. It converted a long and tedious paper-based process into a convenient and efficient referral system.

Eden Mendoza-Hisey

12:43 - 12:51: OA-36-722-24-Improving TB preventive therapy data quality in Ethiopia High quality, patient-level data are essential to advance tuberculosis (TB) prevention for people living with HIV. We present results of a data quality improvement initiative for TB preventive therapy initiation/completion, as well as viral load status in electronic medical records, for tracking Ethiopia’s progress toward TB-HIV epidemic control

Biniyam Eskinder

12:51 - 12:59: OA-36-723-24-Treating viral infections and TB with antibiotics in Viet Nam: is there any financial benefits for community pharmacies? This study evaluated the costs of pharmaceutical management of viral infections and tuberculosis in four provinces of Viet Nam using simulated patient survey data. The findings encourage policies that reduce the inappropriate use of antibiotics for viral illnesses in order to reduce patients’ out-of-pocket expense and improve the quality of care in Viet Nam.

Tho Dang

12:59 - 13:07: OA-36-724-24-Engaging private sector drug retailers in Nigeria’s effort to improve TB case identification: screening and diagnostic gaps from mystery client survey in two states Using a mystery client survey methodology, this study examines trained drug retailers’ ability to appropriately identify and manage presumptive tuberculosis (TB) patients in urban Nigeria. Though results reveal minimal unauthorised dispensing of TB drugs, providers missed opportunities for screening and often failed to refer or initiate sputum collection for TB diagnosis.

Sophie Faye

13:07 - 13:15: OA-36-725-24-Exploring the attitudes and practices of pharmacy professionals towards dispensing national TB programme-provided fixed-dosed combinations While fixed-dose combinations (FDCs) for tuberculosis (TB) have been recommended as the standard treatment, Indonesia’s private TB market is dominated by first line, single-formulation drugs. This digital, cross-sectional study explored the pharmacy professional practices and attitudes toward dispensing national TB programme-provided FDCs to increase its availability for patients through pharmacy channels.

Vania Gones

13:15 - 13:23: OA-36-726-24-Assessing antibiotic sales for presumptive and multidrug-resistant TB patients by community pharmacies in Viet Nam: a standardised patients survey The inappropriate use of antibiotics has been a key driver of antimicrobial resistance. We evaluated antibiotics sales in community pharmacies within Viet Na, using a standardised patient survey, for standardised patients presenting with presumptive tuberculosis (TB) and multidrug-resistant TB.

Shukry Zawahir

13:23 - 13:31: OA-36-727-24-The impact of patent medicine vendors in increasing TB case detection among hard-to-reach dwellers in selected districts in Nasarawa State, Nigeria Patent medicine vendors (PMVs) remains a feature of the informal health sector in Nigeria. Previous studies among patients with chronic cough revealed that 60% of respondents seek first level care from the PMVs, hence engaging PMVs promises increased tuberculosis detection. This abstract presents results of our PMV intervention in Nigeria.

Maxwell Onuoha

13:31 - 13:50: Q&A


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OA-37-TB and HIV potpourri
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OA-37-TB and HIV potpourri
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12:30 - 12:35: Introduction


12:35 - 12:43: OA-37-728-24-Depression and its associated factors in persons with multidrug-resistant TB in Myanmar Depression is identified as an important potential comorbidity in persons with tuberculosis (TB), yet data in many settings are scarce. The present study aimed to estimate the prevalence and risk factors of depression in persons with multidrug-resistant TB in Yangon, Myanmar. Relatively high prevalence of depression has been identified in this study.

Phyo Theingi

12:43 - 12:51: OA-37-729-24-Enteropathogens negatively impact antimycobacterial drug pharmacokinetics in children from rural Tanzania Malnourished children undergoing tuberculosis (TB) treatment in rural Tanzania had poor attainment of antimycobacterial pharmacokinetic targets. Overall enteropathogen-burden and bacterial enteropathogen- burden was identified as a risk factor for sub-target rifampin, isoniazid, and ethambutol serum concentrations.

Daniel Van Aartsen

12:51 - 12:59: OA-37-730-24-Finding the missing cases 0ne-by-two: testing contacts of people with presumptive TB to close TB and HIV case finding gaps in the Democratic Republic of Congo Community outreach efforts to identify missing cases are critical to achieving tuberculosis (TB) and HIV epidemic control goals. The United States Agency for International Development-funded integrated HIV/AIDS project in Haut Katanga (IHAP-HK) piloted the one-by-two approach, which was successful in earlier diagnosis of people with TB or HIV who may otherwise have been missed or diagnosed later through usual tracing efforts.  

Charlie Banzakadilo

12:59 - 13:07: OA-37-732-24-Determining the prevalence of TB in emergency departments in the Eastern Cape region of South Africa and the utility of the WHO TB screening tool This study aims to determine the prevalence of tuberculosis (TB) in emergency departments in South Africa and the effectiveness of the World Health Organization (WHO) TB screening tool. While the WHO screening guidelines identify some TB-positive patients, the inclusion of additional criteria could increase the utility of this tool.

Jacob Roberts

13:07 - 13:15: OA-37-733-24-An in vitro intracellular Mycobacterium tuberculosis and HIV-1 co-infection model suitable for imaging-based platforms Mycobacterium tuberculosis (Mtb) and HIV-1 are hazard group 3 pathogens, as such they are worked with and stored in containment level 3 laboratories. The aim of this work was to develop a safe methodology to co-infect macrophage cells with Mtb and HIV-1 to monitor pathogen interactions for drug screening purposes.

Samantha Donnellan

13:15 - 13:23: OA-37-734-24-Impact of integrating mental health services within existing TB treatment facilities Patients with tuberculosis (TB) are at a higher risk of developing depression and anxiety, which can adversely impact treatment adherence. This study evaluates whether the integration of mental health services within TB programmes can help to alleviate symptoms of depression and anxiety and improve TB treatment completion among drug-susceptible TB patients.

Aneeta Pasha

13:23 - 13:50: Q&A


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SP-43-COVID-19 in pregnant women
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SP-43-COVID-19 in pregnant women
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Immunologic and physiologic changes occur rapidly in pregnancy and may impact pathogenesis, clinical presentation and transmission of SARS-CoV-2, complicating management and leading to poor maternal-foetal outcomes in some cases. Recent reports of asymptomatic women admitted for delivery services have led some settings to initiate universal screening. This symposium will feature emerging research on the immunology of COVID-19 in pregnancy and the differences in clinical presentation and management - including treatment options, policies for safe pregnancy and potential research priorities - which will improve our understanding of this devastating pandemic in all populations.

12:30 - 12:35: Introduction

12:35 - 12:45: Pathogenesis and immunology of COVID-19 in pregnant womenThe Washington State COVID-19 in Pregnancy Collaborative was established to identify known pregnant COVID-19 cases from 16 major tertiary referral centres and community hospitals representing >40% of the ~86,000 annual deliveries in Washington State. In order to improve our understanding of how SARS-CoV-2, the virus that causes COVID-19 impacts the health of pregnant women and their newborns, a multipronged approach is needed, including population-based efforts to describe pregnancy outcomes among women with COVID-19, as well as detailed immunologic studies including placental innate immune responses to SARS-CoV-2. We will discuss the pathogenesis and immunology of COVID-19 in pregnancy, including lessons learned from other emerging infectious diseases.
Kristina Adams Waldorf

12:45 - 12:55: Pregnancy and postpartum outcomes of COVID-19 in New York City: a multicentre prospective cohort studyOver 700,000 confirmed cases of SARS-CoV-2 and 20,000 deaths from COVID-19 have occurred in New York City, making it the epicentre of the infection with fatalities topping that of many European countries. Early in the pandemic, pregnant women were noted to be asymptomatic carriers of SARS-CoV-2, and New York rapidly instated a universal screening programme. In this talk, the findings from this prospective cohort will be discussed, including maternal presentation, obstetric and neonatal outcomes, and placental pathology associated with COVID-19 infection. We will also discuss the evolution of maternal symptoms throughout the course of labour and the postpartum period, with implications for postpartum care.
Malavika Prabhu

12:55 - 13:05: Use of remdesivir for moderate to severe COVID-19 in pregnancyRemdesivir is one of the promising treatments being investigated for the treatment of COVID-19. Gilead, the manufacturer of remdesivir, allowed compassionate use of remdesivir for pregnant women with moderate to severe COVID-19. In this talk, they will present the experience of 86 pregnant women, who received compassionate-use remdesivir, including baseline demographic and clinical characteristics, their time to recovery and time to discharge. For women who delivered, birth outcomes and postpartum complications will be characterised. This data will be important groundwork for future clinical trials that include pregnant women.
Moupali Das

13:05 - 13:15: Crowd-sourcing knowledge for COVID-19 in pregnancy with the World Health Organization registry: potential for maternal TB and beyond?To understand how SARS-CoV-2 infection during pregnancy impacts COVID and pregnancy and postpartum outcomes, the World Health Organization (WHO) has developed a standardised clinical registration platform with a specific module targeting pregnant women. Further, a standardised research protocol has been designed. The protocol allows each site to adapt, based on resource availability and local circumstances, and provides the option to focus on national analyses or participate in pooling. Knowledge of tuberculosis (TB) in pregnancy is still scarce. This presentation will discuss possibilities to build on experiences through different methods related to SARS-CoV-2 and possible implication to TB.
Anna Thorson

13:15 - 13:50: Q&A session

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P4-Greed, smoke and lung health
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P4-Greed, smoke and lung health
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The adverse impact of natural disasters, practices such as deforestation and agricultural burning and man-made products such as tobacco and nicotine on environmental determinants of health, such as clean air, cannot be ignored.  And yet, industries profiting from these practices and products continue business as usual with minimal consideration of these problems.  “Reduced Risk Products” are presented as safer alternatives to cigarettes. Ineffective and insufficient methods to mitigate climate crisis are proposed – delaying meaningful action.  The fight for lung health must include addressing these major contributors to lung health issues in an effective manner, to protect the health of all people, in particular the most vulnerable.

14:00 - 14:03: Session introduction


14:03 - 14:18: PL4A-New generation tobacco and nicotine products: are they harmless?

Jorgen Vestbo

14:18 - 14:33: PL4B-Landscape fires, smoke, and lung health

Fay Johnston

14:33 - 14:48: PL4C-Outdoor and household air pollution - the personal cost

Elvis Ndikum Achiri

14:48 - 14:58: PL4D-Moderated panel discussion


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SP-47-Youth mobilisation to boost the fight to End TB
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SP-47-Youth mobilisation to boost the fight to End TB
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In 2019, the World Health Organization (WHO) launched the 1+1 initiative; calling for youth mobilisation to boost the fight to End TB. At the first ever Global Youth Town Hall on Ending TB, over 200 youth pledged their commitment by adopting the Youth Declaration to End TB. This declaration outlines key areas where youth can contribute: increasing awareness, fighting stigma and discrimination, patient support, increasing innovation, funding, and multisectoral action. In this session, we present innovative ideas and experiences to operationalise these commitments. The presentations will be informed by a WHO online consultation that delivers innovative solutions through the creativity and diversity of global youth.

15:00 - 15:05: Introduction

15:05 - 15:15: Mobilising young people as powerful advocates to end TBDespite being the world’s top infectious killer, awareness about tuberculosis (TB) is poor, especially among young people who are among those most affected. Information campaigns, peer education and community mobilisation, through social media and in-person, are some ways that Madhusudan has reached thousands of young people. In this presentation he talks about what he has learnt about educating, mobilising and motivating young people to become leading voices in the fight to end TB. He also presents the results of the online consultation, which take these learnings and applies them to new and innovative approaches for reaching young people.
Madhusudan Kaphle

15:15 - 15:25: Making solidarity infectious: how young people can fight stigma and discrimination against people with TBPeople with tuberculosis (TB) face immense stigma and discrimination that can hamper their access to care, as well as their psychosocial wellbeing. While young people are traditionally social justice champions, what role can they play in raising awareness and fighting stigma for TB patients?  Paran looks at this from her personal experience as a TB survivor and advocate, as well as experiences collected from around the world and through the online consultation.
Paran Sarimita Winarni

15:25 - 15:35: Not just diagnostics and medicines: how young people can support those with TB through treatment and recoveryPeople with tuberculosis (TB) face a challenging recovery period and need psychosocial and socioeconomic support to complete their treatment and lead fulfilling lives after surviving the disease. How can young people contribute to this? Funke Dosumu, a TB survivor and advocate, looks at the role each young person can play in supporting TB patients, including using new digital tools to respond better to this need.
Funke Dosumu

15:35 - 15:45: Getting invested: young people’s role in bringing all of society on board and increasing funding to end TBHow do you bring society to take ownership of its tuberculosis (TB) response – addressing not only the healthcare aspects, but the social determinants of the disease? Along with the ministry of health, how do we include other ministries such as for disabilities, for women and child health, for education, for labour, for finance in the response? How do we involve local governments, mobilise the private sector and activate civil society? Hai will speak about an all-of-society approach to ending TB, building on experience from Viet Nam, as well as an international stage and the online consultation.
Hai Nguyen

15:45 - 16:20: Q&A session

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Community Connect
Addressing Barriers to Addressing Treatment and Care
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Addressing Barriers to Addressing Treatment and Care
Despite initial investment in health system strengthening investments in Kono District, a rural and impoverished mining district in Sierra Leone that was heavily effected by both the Ebola outbreak and the civil war, over 50% of expected tuberculosis (TB) cases, especially among women and children, remain unregistered. This grievance is due to immerse geographical and socio-economic barriers faced by patients, many of which lost faith in formal care provision during the Ebola crisis. For example, some patients spend up to five hours on a motorbike to reach the nearest TB diagnostic and treatment site and such challenges are particularly pertinent for women, who have been reported to have less financial autonomy and mobility in rural Sierra Leone. To tackle such barriers, the MIND-TB project aims at increasing access to TB diagnosis, treatment and adherence by a) engaging informal providers such as traditional healers and matriarchal caregivers in TB screening and community sensitization b) conducting home-based sputum collection and contact-tracing through Community Health Workers and c) by increasing district-wide GeneXpert testing. This is supported by the implementation of a mobile application ( CommCare by Dimagi) that health providers, including informal (and often illiterate) ones, use to track patients at all points of care using geo- and time-tags, hence allowing for timely coordination and follow-up of sputum and patient referrals between providers using community health workers, traditional healers, informal providers (Traditional healers, Caregivers, Drugstore owners), and the use of nutrition program for known TB patients in the district to bridge barriers to TB treatment and care in Kono district.

Speaker
Fodey Boima
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Channel 1
OA-39-The Union/CDC late-breaker session on TB
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OA-39-The Union/CDC late-breaker session on TB
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15:00 - 15:05: Introduction


15:05 - 15:13: LB-2112-24-Diagnostic accuracy, clinical impact and antimicrobial resistance consequences of using trial-of-antibiotics for TB diagnosis: a randomised controlled trial in Malawi (ACT-TB study) Antibiotics, commonly used during tuberculosis (TB) diagnosis, have unknown diagnostic accuracy and effectiveness. This three-arm randomised trial in Malawi (azithromycin versus amoxycillin versus standard of care) showed modest, increased specificity with immediate antibiotics, but no other clinical benefit on missed TB diagnosis, hospitalisation or death. Trial-of-antibiotics, therefore, offers only limited benefit.

Titus Divala

15:13 - 15:21: LB-2087-24-Xpert performance evaluation for linkage to TB care (XPEL TB): a cluster randomised trial An ultra-pragmatic cluster randomised trial was conducted to evaluate the effectiveness of a streamlined tuberculosis (TB) diagnostic strategy, centred around onsite Xpert testing at 20 health centres in Uganda. This intervention increased 14-day TB treatment initiation by 56% and improved quality metrics along the entire TB diagnostic evaluation cascade of care.

Achilles Katamba

15:21 - 15:29: LB-2110-24-Comparable diagnostic performance of the T-SPOT TB test, using manual density gradient cell isolation, versus automated positive selection with the T-Cell TM Kit This prospective study aimed to compare the T-SPOT tuberculosis (TB) test, using peripheral blood mononuclear cells (PBMCs) isolated via manual density gradient separation (reference) performed between 0-8 hours after blood collection, versus automated positive selection with magnetic bead isolation with the T-Cell TM Kit performed between 0-55 hours post collection.

Shu-Hua Wang

15:29 - 15:37: LB-2070-24-Deep learning algorithm classifies active TB from normal - and other abnormal - chest X-rays with high accuracy on large scale dataset An artificial intelligence algorithm, trained and tested on a large scale dataset, can classify active tuberculosis (TB) from normal - and other abnormal - chest X-rays with high accuracy. It can be applied in TB screening programmes where a large amount of population are evaluated in a short period of time with limited radiologists.

Yuan Li

15:37 - 15:45: LB-2127-24-Tool to assess willingness to prescribe TB preventative therapy among healthcare workers in rural South Africa A tool to assess healthcare worker willingness to prescribe tuberculosis preventative therapy (TPT), in rural South Africa, was derived using exploratory factor and regression analyses. Such a tool is relevant as TPT initiation rates have decreased among people living with HIV despite South Africa's initial successful TPT roll out.

Amiya Ahmed

15:45 - 15:53: LB-2056-24-Shorter treatment for minimal TB in children: main findings from the SHINE trial SHINE was an open-label treatment shortening trial in children with minimal (non-severe and smear-negative), symptomatic drug-susceptible tuberculosis (TB). One thousand, two hundred and four children in Africa and India were randomised to four-month versus six-month treatment, using World Health Organization-recommended paediatric fixed-dose formulations, and followed for 18 months. Here we will be presenting the main trial results.

Eric Wobudeya

15:53 - 16:01: LB-2046-24-Temporal non-adherence and TB treatment outcomes? ‘O art of subtlety and secrecy!’ When adherence to anti-tuberculosis medication is considered, adherence levels are frequently reduced to binary categorisations (above 80/90% is ‘good’), ignoring their temporal subtleties and the intricacies of the adherence-outcome relationship. We sought to determine this relationship in detail, including the dynamics of adherence between the initiation and continuation phases.

Helen R. Stagg

16:01 - 16:20: Q&A


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SP-48-Understanding the impact of participatory approaches in developing sustainable TB policies
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SP-48-Understanding the impact of participatory approaches in developing sustainable TB policies
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While there is increasing awareness of the importance of engaging civil society, many countries and regions are not yet truly implementing it. Using examples from work in the World Health Organization Europe Region, this session will demonstrate the impact that participatory approaches (that involve community groups, key populations and patients) have had.  The TB Europe Coalition has been working for a number of years, joining civil society and policy makers, to build sustainable TB policy through national dialogues. This symposium aims to encourage countries to build participatory approaches into their policy planning and inform civil society about best practice in this regard.

15:00 - 15:05: Introduction

15:05 - 15:15: The role of national dialogues in ensuring policy sustainability: best practices and lessons learnedUsing the TB Europe Coalition’s extensive experience facilitating national dialogues for participation in policy making, Mariya Makovetska will present the best practices that have been developed in this area to bridge the gap between civil society organisations and the health services to provide people-centred tuberculosis services and lessons learned, for other organisations and regions to use and adapt.
Mariya Makovetska

15:15 - 15:25: Barriers to participatory approaches to policy makingWhile there is increasing recognition of the importance of participatory approaches, this is by no means universal. In this presentation, Paul Sommerfeld will highlight some of the main barriers that TBEC has faced in its work in this regard over the past decade. He will also explore some of the paths he has taken to overcome obstacles and ensure the successful inclusion of civil society groups in policy change. This provides an opportunity for other groups to learn and develop their own strategies.
Paul Sommerfeld

15:25 - 15:35: Civil society on the road to a TB lawIn November 2018, Romania adopted a law for tuberculosis (TB) prevention and control. This includes sick leave entitlement throughout treatment and ambulatory nutritional support. The process of ensuring the law’s adoption was a long process, taking years of consolidated work from civil society. In this presentation, Cristina will explore the ways that civil society groups and individuals worked to ensure the law’s adoption over this period, providing lessons for other countries, as well as demonstrating the vital role of individual and organisational participation in policy development.
Cristina Enache

15:35 - 15:45: Participatory approaches in action: collaboration between the World Health Organization and civil society to end TBThe panel presentation will reflect on the collaboration between the Word Health Organization (WHO) and civil society within the aspects of the participatory approaches, including WHO ENGAGE-TB framework.  This can be seen in the establishment of the WHO Civil Society Task Force on TB and the RCC-THV. Throughout the last few years, the participation of civil society and TB-affected communities in NTP reviews has been facilitated through the support of the WHO Regional Office for Europe. This engagement allowed for grassroots perspectives as to the success and barriers in TB programmes to be voiced, as well as providing recommendations for the format of quality people-centred care based on the personal experience of former patients.
The presentation will raise awareness of the interested stakeholders on the opportunities for participatory approaches to end TB as well as further areas of strengthening intersectorial collaboration.
Yuliya Chorna

15:45 - 15:55: Civil society participation in policy development in AzerbaijanParticipatory initiatives in Azerbaijan, including national dialogues, have been very successful in building the political will to end tuberculosis (TB). After the national dialogue, the government announced a call for proposals on two TB grants and the national strategic plan was developed with the participation of NGOs. In this presentation, Elchin Mukhtarli will explain the impact of national dialogues in developing and improving policy regarding TB. Through this work, intersectorial partnerships (between CSO and parliamentarians, CSO and NTP etc.) have been established, a patients’ community network was created and many more activities have been successfully conducted. Of particular importance has been NGO involvement in the continuation of treatment for people with TB after release from prison. Initially, treatment continuation rates were at approximately 10%. However, following CSO involvement in care in 2011, these have risen to 97%.
Parvana Valiyeva

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

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