19 October-1 December 2020
The 51st Union World Conference On Lung Health
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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
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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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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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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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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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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E-posters
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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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

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

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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E-posters
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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OA-10-Partnerships for integrating services
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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-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-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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SP-25-It takes more than bandwidth - using the Extension for Community Healthcare Outcomes virtual community of practice model to build local health workforce capacity.
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SP-25-It takes more than bandwidth - using the Extension for Community Healthcare Outcomes virtual community of practice model to build local health workforce capacity.
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Countries with a high burden of tuberculosis (TB) are implementing the ECHO (Extension for Community Healthcare Outcomes) telementoring model — based on a combination of video conferencing, case-based learning, sharing of best practices and monitoring outcomes — to target communities where health disparities are the greatest. We will introduce participants to the basic principles of the ECHO virtual community of practice model that connects national and international experts with local TB practitioners, highlight innovative and sustainable examples of implementation in a variety of country contexts, and promote discussion around the challenges and opportunities for adapting the model to TB education and workforce development globally.

16:30 - 16:35: Introduction

16:35 - 16:45: National Initiative to Strengthen Collaboration between HIV-TB through e-learning (e-NISCHIT) in IndiaIn 2017, the national AIDS and TB programs introduced conceptual changes in TB guidelines, wherein TB treatment for PLHIV was shifted from TB to HIV clinics. Initial experience pointed towards a countrywide need for mentoring of HIV teams in clinical and programmatic management of TB. An HIV-TB ECHO program, e-NISCHIT, was started in 2018, in collaboration with Government of India, CDC, Share India and ECHO India. National Institute of TB is the hub for this program and state run HIV Clinics from two states each of North and South India (~100 clinics) were selected to be the initial spokes. This program has successfully conducted 52 sessions to date, enabling rapid percolation of TB/HIV guidelines and handholding of peripheral HIV teams to undertake optimal TB management. The GOI has recently extended this program to areas with high prevalence of both HIV and TB in India's northeast and plans to expand nationwide.
Upasna Agarwal

16:45 - 16:55: Ensuring quality TB and specialty care for underserved patientsDespite universal access to tuberculosis (TB) diagnosis and treatment in Georgia, TB services in rural and underserved areas of the country are still unevenly distributed; there is a lack of access to multi-disciplinary and specialty care, as well as to the latest updates and innovations in TB diagnosis, patient care and treatment. As a result, the majority of TB patients are referred to the central TB treatment facility to receive quality TB and specialty care. To overcome the challenges of delayed treatment initiation and minimize time and costs of patient travel to central facilities, Project TB-ECHO was implemented in late 2017 and fully functional since early 2018. Over 800 patient cases have been discussed since ECHO implementation which gives the country a hope to soon have a significant improvement in the number of lost to follow-up cases, increased treatment success and enhanced capacity of human resources on all country levels.
Mariana Buziashvilli

16:55 - 17:05: Building a Community of Practice for TB Program Managers - Utilizing the ECHO ModelThe National Tuberculosis Controllers Association (NTCA) is the premier organization in the United States representing tuberculosis (TB) public health programs; NTCA has evolved as a non-profit, professional member service organization and has over 600 members from every state, city, and territorial TB program. NTCA wanted to enhance networking and educational opportunities to meet the unique needs of TB program managers responsible for overall program administration. The NTCA launched its first Community of Practice session on July 11, 2019 with 56 participants from across the United States.  The initial sessions (296 participants) focused on writing and preparing the CDC TB Cooperative Agreement 2020 Notice of Funding Opportunity.  Series Two, (161 total participants) focused on writing the CDC Cooperative Agreement Five Year Progress Report. Series Three, (237 participants) focused on the maintenance of TB programmatic and clinical activities despite the pressing COVID-19 responsibilities added to TB programs.
Diana Fortune

17:05 - 17:15: Expansion of the Regional TB ECHO Program across Central AmericaThe CDC Central America Regional (CAR) Office provides technical assistance to Ministries of Health in the region through a PEPFAR funded TB/HIV program. In 2019, WHO reported 14,353 TB cases in CAR including 1123 cases ofTB/HIV in the region of seven countries. Some of the challenges faced to obtain TB epidemic control in rural areas are lack of resources, poor referral of patients for care and treatment, difficult to reach communities and lack of specialized trained physicians to treat TB. From 2018-2019, CDC CAR launched three TB ECHOs in Guatemala, Panama and Honduras. The TB ECHO program in Guatemala included a 6-month TB basics national certificate program and trained around 300 healthcare workers. In addition to the national programs, CDC CAR and its partner SE-COMISCA (Commission of Ministries of Health in the region) launched a regional program in May 2020 to discuss common challenges for all countries such as TB cases in immigrants, people living with HIV, diabetes and COVID-19.
Diana Patricia Forno

17:15 - 17:25: Advancing Prevention in Massachusetts, USA - Implementing the ECHO model to increase latent tuberculosis infection testing and treatment in primary careIn 2016, the US Preventive Services Task Force updated recommendations to support latent tuberculosis infection(LTBI) testing as a preventive strategy and recommended that primary care providers(PCPs) integrate LTBI management into their primary care practices. PCPs rarely receive sufficient LTBI training and feel uncomfortable prescribing rifampin and isoniazid. In 2019, the Massachusetts (MA) Department of Health partnered with the University of MA Project ECHO hub to design a LTBI ECHO. The course incorporates six virtual telementoring sessions for MA PCPs. A mixed-methods program evaluation was conducted. Pre- and post quantitative structured surveys were administered to LTBI ECHO course participants. Qualitative in-depth interviews were conducted with participants and content experts to assess resulting practice changes and recommendations. We found that our LTBI ECHO course increases PCPs knowledge and confidence and supports practice change. Health departments may find LTBI ECHO programs to be an effective intervention to train PCPs in LTBI management.  
Daria Szkwarko

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

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OA-21-Finding missing people with TB: targeted approaches
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OA-21-Finding missing people with TB: targeted approaches
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16:30 - 16:35: Introduction


16:35 - 16:43: OA-21-626-22-TB screening and treatment by neo-literate community volunteers among tribal populations in insurgency hit Swabhiman Anchal saved lives and livelihoods in Malkangiri district, Odisha Tuberculosis (TB) screening and treatment by neo/semi-literate community volunteers among tribal populations in insurgency hit Swabhiman Anchal (cut-off area) saved lives and livelihoods in Malkangiri district, Odisha. Engaging the community themselves and adapting out-of-box strategies brought a significant impact on the disease prevalence and mortality among such a community.

Gayadhar Mallick

16:43 - 16:51: OA-21-627-22-Investigating the feasibility of universal screenings and instituional treatment support of the homeless population through a mobile digital X-ray and CBNAAT algorithm in India A pilot study demonstrated the efficacy of a universal screening test, using a mobile digital X-ray and CBNAAT algorithm, and the high, untreated burden of tuberculosis (TB) among the homeless population in Delhi.  It also pointed to the importance of a diversity of treatment support mechanisms required for treatment completion.

Armaan Mullick Alkazi

16:51 - 16:59: OA-21-628-22-Risk factors associated with loss to follow-up among multidrug-resistant TB patients in Ukraine Risk factors associated with loss to follow-up (LTFU) among multidrug-resistant (MDR-TB) patients in Ukraine. Our data reinforced the concept that LTFU in MDR-TB is a serious public health problem and that adequate follow-up of treatment is necessary, along with the expansion of social support programmes for patients, in order to avoid unfavourable outcomes.

Olha Zaitseva

16:59 - 17:07: OA-21-629-22-Promoting a community-led, multisectoral and collaborative response to TB: learnings from India Globally, the tuberculosis (TB) response has remained largely biomedical, with minimal involvement of communities and other actors. An intervention to engage previously un-engaged stakeholders and to broaden the conversation around TB was implemented in India between 2016-2019 and affirmed that a multisectoral, community-led approach is essential to trigger collective action.

Anupama Srinivasan

17:07 - 17:15: OA-21-630-22-Towards a Nairobi TB free city: engaging city authorities towards the elimination of TB: the case of the Nairobi City County government Local city authorities play a critical role towards attainment of the End TB Strategy goals. However, their engagement has been challenging in many countries. This presentation outlines key steps towards successful engagement of city authorities in tuberculosis (TB) activities to ensure ownership and sustainability of efforts towards ending TB.

Ann Masese

17:15 - 17:23: OA-21-631-22-Maintaining TB care and management through community refills in a high HIV-TB-burden setting in the era of COVID-19 TB-HIV care was provided in the community due to COVID-19 measures, which limited the ability of patients to come to the clinic for routine care and drug refills. The community programme implementation alleviated travel challenges and led clinicians to also understand community influences in accessing to care.

Hloniphile Gama

17:23 - 17:31: OA-21-632-22-A WhatsApp-based interactive communication strategy to reduce initial loss to follow-up among presumptive TB patients in a high-incidence setting Delays and losses along the tuberculosis (TB) care cascade constitute important challenges for TB programmes. Mobile messaging services, such as WhatsApp, might help mitigate these challenges. We developed and piloted a WhatsApp-based interactive communication intervention to reduce initial loss to follow-up among individuals awaiting TB test results in a high-incidence setting.



Florian M. Marx

17:31 - 17:50: Q&A


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E-posters
EP20-Community healthcare workers in evidence
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EP20-Community healthcare workers in evidence
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

EP20-288-23-Household contact tracing of pulmonary bacteriologically-confirmed TB patients by community health workers in Bumula sub-countyCommunity health workers can effectively implement household contact tracing in resource-limited settings. Contact tracing of bacteriologically-confirmed tuberculosis (TB) patients is a strategy that can be used in finding the missing TB cases and to increase the uptake of isoniazid preventive therapy in children under 5 years of age.
Robert Magomere

EP20-289-23-“After we gave their children polio vaccine we also asked if anyone was coughing"..... exploring programme integration through experiences of front line health workers in NigeriaA phenomenological qualitative research methodology was used to explore health workers' perception of programme integration. We found that simple interventions with minimal documentation can be successfully integrated at the community level. The strengths of the polio vaccination intervention were leveraged to improve tuberculosis control in our setting.
Chukwuebuka Ugwu

EP20-290-23-Can point-of-care CRP improve symptom-based TB screening for detection of TB in the community?New tools for screening tuberculosis (TB) are required in high-burden settings. We evaluated the performance of point-of-care (POC) C-reactive protein (CRP) alone, and in combination with symptom screening, for identifying TB in the community in 701 participants from Zambia and South Africa.
Maria Ruperez

EP20-292-23-The roles of community cadres in applying virtual case finding due to the COVID-19 pandemicIndonesia is still facing challenges in tuberculosis (TB) case finding as the preventive action for TB transmission. Home visits by community cadres for contact investigation is the key strategy.  But this activity had to stop because of the COVID-19 pandemic.  Now, virtual screening is an alternative for case finding.
Esty Febriani

EP20-293-23-Finding missing people with TB: the role of community health workers/volunteers in TB contact tracing in Tanzania (January–March 2020)Finding missing people with tuberculosis (TB) using community health workers/volunteers is of paramount importance in attaining the United Nations High-Level Meeting targets. The overwhelmed health facility staff and TB coordinators need to engage community platforms and link with the confirmed TB patient's contacts for follow-up in the community.
Godwin Munuo

EP20-294-23-Community health workers at the front line: task shifting shows high TB sputum rates at primary healthcare level in King Cetshwayo District, KwaZulu-Natal, South AfricaTrained community health workers take on important activities to improve case finding, diagnosis and support of drug-sensitive tuberculosis (TB) patients in a semi-rural, resource-constrained high TB burden setting of the province of KwaZulu-Natal in South Africa.
Liesbet Ohler

EP20-295-23-The comparative yield of contact investigations from an index patient-led contact tracing approach and a community healthcare provider-led approachThe comparative yield of contact investigations from an index, patient-led contact tracing approach and a community healthcare provider-led approach, showed that index patient-led contact tracing is an effective approach for finding missed tuberculosis (TB) cases quickly and could be employed among youths and communities with high stigma index.
Catherine Kunihira

EP20-296-23-Improving systematic TB case finding for community platforms in low-resource settings in Lao PDRThe Lao PDR National TB Center implemented a comprehensive tuberculosis (TB) case finding model in two districts in Champasack province. The systematic case finding pilot engaged village heath workers to screen symptomatic persons and identify vulnerable population and to refer both groups for 100% GeneXpert testing to improve treatment coverage rates.
Sakhone Suthepmany

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EP24-TB innovative strategies to find the missing cases
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EP24-TB innovative strategies to find the missing cases
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EP24-325-23-Engaging patient medical vendors in TB case finding: the pros and consPatient Medical Vendors (PMVs) are an informal medical outfit that are widely patronised by the majority of the populace in Anambra State Nigeria, this Global fund Caritas Nigeria private sector intervention rant engaged PMVS for TB case finding, this Abstract reviewed the process of engagement, their Case contribution and challenges encountered.
Chidimma Ezeobi -Okoye

EP24-326-23-Enhancing TB diagnosis among unengaged, standalone, formal and informal private health facilities in finding missing people with TB in KenyaPrivate provider engagement (PPE): enhancing TB diagnosis among unengaged, standalone, formal and informal private health facilities to find missing people in Kenya with tuberculosis through capacity building of the providers, strengthening linkages and the provision of sample transport mechanism.
John M. Ng'ang'a

EP24-327-23-The role of community-based interventions to reach out to underserved populations and increase the success rate of TB treatment in Gaza Province, Mozambique, 2019The following abstract assesses the strategy to provide tuberculosis (TB) services to hard-to-reach communities in a low-income setting through active case finding in Gaza. This province aggregates key TB determinants, such as historic mining migration to South Africa and the high burden of HIV. 
Bachir Macuacua

EP24-328-23-TB active case finding in fragile post-conflict areas in Darfur, SudanTuberculosis (TB) services in the Al Malha locality were, throughout the years, affected by the Darfur conflict. TB active case finding was adopted to increase case detection rates, improve the quality of the TB services and increase health awareness. Unfortunately, after finishing the project the TBMU was closed. 
Muaz Hassan

EP24-329-23-Low male yield from community-based TB contact tracing: experiences from community contact tracing in LesothoLesotho is a high tuberculosis (TB) burden country with low treatment coverage. Community TB contact tracing, adopted to improve case finding, appears to be missing men. We analysed programme performance across the contact tracing cascade to look for differences by age and sex.
Tafadzwa Chakare

EP24-330-23-TB screening at Bungoma Bus Park, Bungoma County, KenyaRegular tuberculosis (TB) screening in bus parks can led to an increase in TB case notification, eventually reducing transmission of TB. Adherence counselling and the provision of TB drugs, during convenient hours, to touts and drivers can reduce TB treatment interruption in this group.
Robert Magomere

EP24-331-23-Yield and coverage of active case finding interventions for TB control in high burden countries: a systematic review and meta-analysisThis systematic review and meta-analysis summarises data on outcomes of active case finding activities. We highlight how, yield of active tuberculosis (TB) cases and screening coverage, differs in various populations and settings, as well as how different screening and diagnostic methods affect the yield of TB cases.
RUTH DEYA

EP24-332-23-An adaptive decision-making approach to efficiently deploy TB case finding in high burden communitiesStrategies are needed to optimise the use of community-based active case finding (ACF) in high tuberculosis (TB) burden communities. We propose an adaptive decision-making approach, which uses a Bayesian sampling algorithm, to guide ACF resource allocation in order to improve case-finding yield in communities with a prevalence of undiagnosed TB.
Abigail de Villiers

EP24-333-23-Patent and propriety medicine vendor-led community engagement: an innovative approach to finding missing TB cases in rural communities in Boki local government, NigeriaThe missing tuberculosis (TB) cases are in the community. Effectively engaging communities in finding missing persons with TB has been both challenging and cost intensive. The patent medicine vendor resides with the people in the community and could have a critical role in engaging communities in finding missing TB cases.
Igbaji Basil Uguge

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OA-22-Improving the quality of care
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OA-22-Improving the quality of care
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11:00 - 11:05: Introduction


11:05 - 11:13: OA-22-633-23-Enhancing early detection of TB through targeted outreach in hotspots: an experience of Amref Health Africa in Kenya Targeted tuberculosis (TB) outreaches in hotspots to enhance early detection of TB in schools, prisons, health facilities, market places and public transport termini: an experience of Amref Health Africa in Kenya in collaboration with the national TB programme.

Alice Wanyonyi

11:13 - 11:21: OA-22-634-23-A precision public health approach to identify at-risk population segments and their drivers for not seeking care for TB We conducted an 84,625 household community-based survey in 2017-2018 in Chennai, India, and prospectively followed 1,667 people with tuberculosis (TB) suggestive symptoms. We identified contextual and perceptual drivers of care-seeking, segmented respondents by care-seeking behaviour using unsupervised clustering, and estimated the percent of population with TB that would fall into each segment.

Tichakunda Mangono

11:21 - 11:29: OA-22-635-23-Implementing the standardised patient method to evaluate quality of TB care among private practitioners in South Africa We evaluated the feasibility of utilising patient actors (standardised patients) to determine the quality of tuberculosis care among private GPs in two South African cities. We describe the feasibility, challenges and implementation outcomes of this mixed methods project.

Jody Boffa

11:29 - 11:37: OA-22-636-23-Using low-cost interventions to improve availability of TB medicine in Uganda Tuberculosis (TB) commodities management in a resource-limited setting is vital in ensuring access to quality TB care and services. This can be achieved through implementation of low-cost, inventory management interventions to improve the availability of, and uninterrupted access to, TB medicine, resulting in better TB treatment outcomes.

Henry Kizito

11:37 - 11:45: OA-22-637-23-How the dual role of community facilitators as sample transporters and TB patient contact tracers increased contacts coverage and TB case finding in Kampala The laboratory network in Uganda is linked by motorcycles transporting samples. The Uganda tuberculosis (TB) prevalence survey highlighted inadequate systems for TB patient contact tracing in communities. Challenges to TB diagnosis included delays in reaching/linking TB patients contacts to facilities. To address these, The United States Agency for International Development's Defeat TB project integrated sample transportation systems with community TB contact tracing.


Ronald Mangeni

11:45 - 11:53: OA-22-638-23-Quality of TB and HIV care among private general practitioners in two South African cities Little is known about the quality of tuberculosis (TB) and TB-HIV care in South Africa's private sector, despite 29% of people with TB symptoms seeking private care first. We report on the quality of TB and HIV management received by patient actors presenting to private GPs in Durban and Cape Town.

Sizulu Moyo

11:53 - 12:01: OA-22-639-23-Understanding the dynamics of antibiotics and steroids prescription prior to TB diagnosis in South Africa’s private sector Antibiotic and steroid use can lead to tuberculosis (TB) diagnostic delay and/or complications with TB treatment. We report insights into prescription dynamics based on the qualitative findings from a quality of TB care study among private general practitioners in an urban centre of South Africa.

Jeremiah Chikovore

12:01 - 12:20: Q&A


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OA-26-Using digital technology for TB elimination
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OA-26-Using digital technology for TB elimination
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12:30 - 12:35: Introduction


12:35 - 12:43: OA-26-661-23-The use of geographic information systems technology and self-reported data to characterise congregate settings with high potential risk for TB transmission in an urban African area The use of geographic information systems technology, coupled with data provided by tuberculosis (TB) cases, can inform local public health interventions which target congregate settings with a high potential risk for TB transmission. In a retrospective cohort study conducted in an urban area in Uganda, we characterised and mapped these high-risk indoor congregate settings.

Maria Eugenia Castellanos Reynosa

12:43 - 12:51: OA-26-662-23-Bundling innovations for public-private mix: experience of artificial intelligence-augmented chest X-Ray screening and TrueLab for diagnosis To increase tuberculosis (TB) case detection in Nagpur slums, a public- private mix intervention was implemented with a novel Qure.ai software installed in private sector chest X-ray labs. Presumptive TB patients with abnormal chest X-ray results were confirmed microbiologically using TrueLab tests in a public sector hospital and linked for public sector treatment.

Shibu Vijayan

12:51 - 12:59: OA-26-663-23-Reducing turnaround time by transitioning from paper-based to digital signature certificate-based approval of direct benefit transfers under National Tuberculosis Elimination Programme, India In order to reduce catastrophic expenditure for various schemes under the National Tuberculosis Elimination Programme, end-to-end digital processing of benefits to various beneficiaries was assessed for feasibility, using Nikshay, the national tuberculosis (TB) patient management system. This demonstrated near real-time communication of process status to all stakeholders, resulting in increased transparency, accountability and process efficiency.

Manu Easow Mathew

12:59 - 13:07: OA-26-664-23-Improving TB patients treatment adherence via electronic monitors and an app vs usual care in Tibet: a pragmatic randomised controlled trial We report the interim analysis of the randomised controlled trial in Tibet, China, that is using electronic monitoring boxes to improve patient adherence to anti-tuberculosis medications. We find e-applications becoming better accepted by healthcare workers and patients during the COVID-19 pandemic period.

Xiaolin Wei

13:07 - 13:15: OA-26-665-23-Preliminary results of a randomised trial comparing traditional in-person directly observed therapy and video-based observed therapy for monitoring TB treatment We conducted a randomised, two-period cross-over trial in New York City tuberculosis (TB) clinics to determine if video-based observed therapy (VOT) is non-inferior to in-person, directly observed therapy (DOT) for assuring adherence to TB treatment. The non-inferiority margin was 10%. We report primary results using intention-to-treat, per protocol, and empiric as-treated approaches.  

Joseph Burzynski

13:15 - 13:23: OA-26-666-23-Assessing adverse events among patients using in-person and electronic directly observed therapy In a randomised cross-over trial comparing in-person directly observed therapy (DOT) with electronic DOT for tuberculosis treatment in New York City, we analysed the reporting and severity of adverse events and the time taken to access care for each DOT method.

Marco M. Salerno

13:23 - 13:50: Q&A


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OA-29-Who pays the cheque? The economic burden of TB
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OA-29-Who pays the cheque? The economic burden of TB
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15:00 - 15:05: Introduction


15:05 - 15:13: OA-29-680-23-Assessing the economic impact of TB mortality in 165 countries: what it will cost if we don’t achieve the End TB targets Tuberculosis (TB) elimination leads to colossal health and development returns. However, evidence on the economics of ending TB remains disparate. We estimate the economic dividend of achieving the End TB mortality target by 2030 and the cost of inaction - the welfare penalty - of not meeting the target until 2045.

Sachin Silva

15:13 - 15:21: OA-29-681-23-First national survey of the costs borne by households with TB in the Democratic Republic of the Congo 2019 The Democratic Republic of the Congo tuberculosis (TB) programme conducted its first national TB patient cost survey in 2019 to establish a baseline for monitoring the progress towards elimination of catastrophic costs, in line with World Health Organization methods. National health and social policy interventions, geared to mitigate newly evidenced economic burden borne by TB patients, require crafting.

Inés Garcia Baena

15:21 - 15:29: OA-29-682-23-Determinants of household catastrophic costs for TB care in Kenya Despite the significant burden of drug-sensitive tuberculosis (DS-TB) cases, little is known about the predictors for catastrophic costs among them. This presentation will share results on the determinants for household catastrophic costs among DS-TB patients in Kenya. This could be the first step in designing tailor-made social interventions.

Beatrice Kirubi

15:29 - 15:37: OA-29-683-23-Economic burden of TB in Tanzania: a national survey of costs faced by TB-affected households Despite free provision of tuberculosis (TB) care, TB-related costs can be overwhelming and sometimes catastrophic for patients and their households, leading to poor treatment adherence and patient outcomes. We conducted a national survey to assess the economic burden of TB on patients and their households in Tanzania in 2019.

Andrew Martin Kilale

15:37 - 15:45: OA-29-684-23-Direct medical costs and out-of-pocket expenditures on TB treatment in three regions of China Although tuberculosis (TB) treatment is free of charge in China, medical costs during the inpatient treatment period still resulted in more than 10% of TB-affected families facing catastrophic costs. During outpatient treatment, the proportion of out-of-pocket expenditures reached almost 50% of direct medical costs because of additional medicines for drug-induced adverse effects.

Xubin Zheng

15:45 - 15:53: OA-29-685-23-Catastrophic costs associated with diagnostic cascade and treatment of TB among patients treated at a public health centre in Rio de Janeiro, Brazil Poor socioeconomic conditions increase the risk for tuberculosis (TB) infection, reactivation and maintenance of TB in the community. We conducted a study involving patients undergoing TB treatment in a municipal health centre in Rio de Janeiro aiming to assess the direct, indirect and catastrophic costs incurred for patients with TB.

Adriana da Silva Rezende Moreira

15:53 - 16:01: OA-29-686-23-Why Cepheid Xpert MTB/RIF and SARS-CoV-2 cartridges should not be sold to low- and middle-income countries at more than $5 per test An independent cost-of-goods analysis of Cepheid’s GeneXpert MTB/RIF and HIV viral load cartridges, currently priced at $9.98 and $14.90 for low- and middle-income countries, indicates that one cartridge can be produced below $5 and can be sold, with profit, for between $5 and $7, including service and maintenance.

Stijn Deborggraeve

16:01 - 16:09: OA-29-687-23-The cost of TB contact investigation in Uganda Tuberculosis (TB) contact investigation has been recommended for a long time. However, it is not being fully implemented in most low- and middle-income countries. One of the main issues raised for this is the cost. We set out to find the cost relative to GDP and we found it to be high.

Michael Kakinda

16:09 - 16:20: Q&A


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EP37-Joining efforts for TB elimination: the role of the private sector
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EP37-Joining efforts for TB elimination: the role of the private sector
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EP37-455-24-Is it worth investing additional resources to catalyse access to TB care in the private sector? An experience from southern IndiaOur study aims to assess the impact of additional project investments on access to TB care services, like microbiological confirmation of diagnosis, universal DST and linkage to government portals by notification, thereby enabling access to incentives etc. Our learning from southern India can be generalised for Indian context and holds high significance in resource-constraint settings.
Vaibhav Ghule

EP37-456-24-The importance of using systematic screening in high TB burden countries to improve case detection rates: a case from private clinical facilities in NigeriaSystematic screening is key to tuberculosis (TB) case detection in high TB burden countries like Nigeria. The United States Agency for International Development SHOPS Plus programme engaged private clinical facilities in Lagos and Kano States to increase case detection though screening and testing. We compared screening, testing and case finding rates between supported hospitals and nursing homes.
Flora Nwagagbo

EP37-458-24-Factors affecting Nigerian private health facilities' TB case finding performance: reviewing programme dataThe United States Agency for International Development's SHOPS Plus Nigeria programme has engaged over 500 private health facilities in Lagos and Kano States to increase case detection. SHOPS Plus assessed the performance of its networked clinical facilities, using service delivery data, so it could better target oversight and diagnostic resources.
Abdu Adamu

EP37-459-24-Improving quality of care in private sector patients: state of Uttar Pradesh, IndiaCase finding in the private sector has been a challenge which was successfully overcome by the Joint Effort for Elimination of Tuberculosis (JEET) project. However, providing quality of care to these diagnosed tuberculosis (TB) patients in the private sector was another area which the JEET team took up as a challenge and managed to improve through state government collaboration.
Bharati Kalottee

EP37-460-24-The experience of engaging private pharmacies in TB case detection in EthiopiaWe present an innovative experience of engaging private pharmacies and drug vendors in tuberculosis (TB) case detection in Ethiopia. By engaging 110 private pharmacies and drug vendors, we contributed to the detection of 699 additional TB cases (21%) compared with a 1% decline in the control zone. The approach should be expanded.
Samson Ogayse

EP37-461-24-The Global Fund public-private mix TB grant: impact in three southern states in NigeriaThe private sector constitutes a majority of the Nigerian healthcare system. However, only 2.5% of these facilities are formally engaged for tuberculosis services, contributing 11% to total case notification in the country. We present the preliminary findings on the impact of private sector engagement in three states of southern Nigeria.
Chukwuka Alphonsus

EP37-462-24-How frequently are TB care providers changed in the private sector in rural Bihar, India?Provider switching can impact patient care and result in a high-cost of care in the private sector. Understanding its nature and reasons are crucial to addressing it in the tuberculosis programmes engaging the private sector.
Smriti Ridhi

EP37-463-24-Initiation of preventive treatment among household contacts of TB patients registered at a private healthcare facility in Karachi, PakistanInvestigation for tuberculosis (TB) infection in household contacts of individuals with known TB, can lead to early diagnosis and prompt treatment initiation as well as helping to reduce the transmission cycle. In 2019, post-exposure treatment (PET) was initiated for household contacts at a specialised TB diagnostic and treatment centre in the private sector Karachi, Pakistan.
Wafa Jamal

EP37-464-24-Emerging trends in private sector notifications in India: experiences from the Joint Effort for Elimination of Tuberculosis projectThe abstract documents the experiences of implementing the Joint Effort for Elimination of Tuberculosis project (JEET) in geographies covered by FIND India and analyses trends over the years. Comparisons have been drawn with districts where JEET is not being implemented.
Aakshi Kalra

EP37-465-24-Establishment of TB Diagnostic Hubs in Selected Private LaboratoriesEstablishing TB diagnostic hubs in urban private facilities that are surrounded by a rich network of spokes reduces access barriers and hence provide a fertile ground for ACF interventions. Hub and spoke model coupled with a web-based system and a rider, minimizes the leakages in the care cascade. 
Drusilla Nyaboke

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EP30-Where are the undiagnosed TB cases?
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EP30-Where are the undiagnosed TB cases?
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EP30-384-24-Active TB case finding targeted at high burden health facilities in Nigeria: results from a pilot interventionSystematic screening for tuberculosis (TB) in health facility settings and among priority groups remains an important active case finding strategy in high TB burden countries. National TB programmes will benefit through more attention to accurate diagnosis and earlier start of treatment.
Chidubem Ogbudebe

EP30-385-24-Improving TB case finding in hospital outpatient departments: lessons from a health system strengthening approachSystematic screening for tuberculosis (TB) in health facility settings and among priority groups remains an important active case finding strategy in high TB burden countries. National TB programmes will benefit through more attention to accurate diagnosis and earlier start of treatment.
Chidubem Ogbudebe

EP30-386-24-Achieving End TB Strategy: screening for TB in pregnant and non-pregnant women in reproductive age group. Findings from an observational study in Pune, IndiaReproductive age women face a higher risk of tuberculosis (TB) transmission, morbidity and mortality. But women’s access to healthcare is restricted. This study discusses prevalence of active/suspected and latent TB in pregnant and non-pregnant women screened for TB in a hospital in Pune, India. It also discusses he challenges faced for screening.
Mallika Alexander

EP30-387-24-Active case finding for TB among factory workers in Punjab, IndiaFactories are one of the key areas for tuberculosis (TB) prevention and control activities. However, an apprehension of losing employment continues to deter factory workers from participating in TB screening. In close co-ordination with factory owners, active case finding at factories can increase awareness and confidence among workers to seek care.
Prachi Shukla

EP30-388-24-TB treatment outcomes among patients identified through active case finding in a high-density, urban township in Lusaka, ZambiaActive case finding is gaining traction as a means to find missing TB cases in communities as we aim to achieve the End TB Strategy. It identifies individuals who otherwise would spread the disease and further fuel the epidemic. Ever wondered what happens to TB patients identified in this manner? 
Sulani Nyimbili

EP30-389-24-The yield of school-based active TB case finding in Oromia Region of EthiopiaIn the Oromia Region of Ethiopia, which has a high TB burden, school-based TB screening is an advantage. Additional TB cases can be identified in school settings and there is the added advantage of engaging school students in community and household presumptive TB referrals.

Bizuneh Alemu Fetenesa

EP30-390-24-Strengthening active TB case finding: results from using an active case finding toolkit at health facilities in UgandaWith one-quarter of estimated tuberculosis (TB) patients missed, the Ugandan Ministry of Health developed active case finding toolkits to improve the quality of TB screening, case detection and treatment at health facilities. Strengthening health worker capacity to implement the toolkit improved performance and should be scaled-up to address gaps in TB notification.
Aldomoro Burua

EP30-391-24-Active TB case finding among HIV key populations and their contacts: an effective intervention modelThe key populations (KPs) for HIV (MSM and FSW) and their close community (KPC) are at an increased risk of tuberculosis (TB). Active TB case finding activities from PSI TOP centres can detect additional TB cases among non PLHIV KPs and their contacts and percentage of TB cases were higher than KPs.
Nandi U

EP30-392-24-Integrating TB case finding into house-to-house polio vaccination campaigns: findings from the July 2019 supplemental immunisation activities in Anambra State, NigeriaWe leveraged the World Health Organization-supported community polio vaccination structure to integrate tuberculosis (TB) case finding into a house-to-house vaccination campaign. Presumptive and confirmed TB cases were reported through the process. Our report shows that the intervention was most productive in peri-urban slums, riverine and hard-to-reach areas. 
Chukwuebuka Ugwu

EP30-393-24-Intensified case finding among outpatients and their companions by using chest X-ray with artificial intelligence software for TB triaging in the PhilippinesThe companions of patients are not usually part of intensified case finding (ICF) for tuberculosis (TB). We included them in ICF in the Philippines by using chest X-ray with artificial intelligence software for TB triage, which resulted in a high TB case yield, from both patients and companions.
Nichel Marquez

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EP31-Allied against TB: new and old partners
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EP31-Allied against TB: new and old partners
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EP31-394-24-TB case yield of at-risk groups using modified screening algorithm in Nigeria secondary and tertiary healthcare facilitiesSystematic screening for tuberculosis (TB) in health facility settings and among priority groups, remains an important active case finding strategy in high burden TB countries. National TB programmes will benefit through more attention to accurate diagnosis and earlier start of treatment.
Chidubem Ogbudebe

EP31-395-24-Engaging informal healthcare providers in TB case identification: experiences from a project in IndiaInformal providers provide the bulk of the initial medical care for people in low-income communities. Tuberculosis (TB) care provided by these informal providers is characterised as non-diagnosis, misdiagnosis and delayed diagnosis and/or inappropriate treatment. Engaging them in TB care is crucial in reducing the delay in diagnosis and for the initiation of treatment.
Ramesh Dasari

EP31-396-24-Key acceptability constructs influence pharmacist participation during a diagnostic referral pilot in Ho Chi Minh City, Viet NamWe conducted a standardised survey to assess the perceptions of private pharmacists, who were engaged and trained as part of a diagnostic referral pilot, on seven constructs of healthcare intervention, acceptability and pilot implementation.
Tran Phuong TM

EP31-397-24-Determinants of TB suspects’ referrals by pharmacies and over-the-counter medicine shop operators for laboratory TB diagnosis in Eastern Region, Ghana: a telephone surveyUptake of community tuberculosis (TB) care in the Eastern region of Ghana is high on account of a collaboration between the regional TB Control programme and pharmacies. The first ever telephone survey in Ghana revealed that pharmacies and over-the-counter shop operators largely support TB referral.
Mavis Pear Kwabla

EP31-398-24-TB care in prisons in New DelhiPrison facilities encounter turmoil in the challenges faced in tuberculosis (TB) control practices due to a continuous high turnover of prisoners. This causes an increased chance of disease transmission in larger communities on their exposure. A cross-sectional survey was conducted utilising active case finding tools to study epidemiological parameters and concoct interventions following their release.
K. K. Chopra

EP31-399-24-How community pharmacies can contribute to early detection and treatment of TB patients in Viet Nam: a cross-sectional, simulated client surveyEarly diagnosis and treatment of tuberculosis (TB) is important for control, particularly in high burden settings. Pharmacies may serve as a conduit for referring presumptive TB patients for clinical investigation. Using a cross-sectional survey, we evaluated if community pharmacies in Viet Nam were capable of referring a simulated client with presumptive TB.
Shukry Zawahir

EP31-400-24-Police become partners in the gight against TB: experience from Kiambu County, KenyaTuberculosis (TB) case identification and infection prevention remain a challenge in the Kenya police service. Police staff, accused persons and reportees are at increased risk of TB due to the overcrowding and poor ventilation of police cells, vans and court holdings. Public health facilities are also less accessible and require travel time.
Gloria Wandeyi

EP31-401-24-Understanding profile and treatment practices of informal health care providers in RIPEND project implementation area, Telangana State, IndiaEngaging informal providers in tuberculosis (TB) care is important as a first point of contact for any initial medical care. It becomes crucial to understand their profile and treatment practices to devise effective mechanisms for their engagement. 

Vikas Panibatla

EP31-402-24-Implementing 100 percent outpatient department screening in a resource- limited setting: what has workedOne hundred percent outpatient department (OPD) screening  for tuberculosis (TB) was implemented in a faith-based hospital to ascertain its impact  on TB case finding using a top to bottom approach. Training and the institution of an OPD team showed a remarkable improvement in the total number of cases identified in this facility.
Chidimma Ezeobi -Okoye

EP31-403-24-Periodic performance review with patent medicine vendors: a fulcrum for improving TB case detection in the community - a case study of Nasarawa state, NigeriaThe search for strategies to effectively engage the private health sector, especially in finding and treating missing tuberculosis (TB) cases, has dominated discussion in recent years. Our intervention engages the patent medicine vendors, through the umbrella associations, in a periodic performance review to enhance TB case detection and notification.
Igbaji Basil Uguge

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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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Channel 5
SP-47-Youth mobilisation to boost the fight to End TB
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query_builder 15:00 - 16:20 | Event time (GMT+2)
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place Online Session/Virtual
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mic English
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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