Sessions

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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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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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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

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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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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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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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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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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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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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