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
*Please scroll down for more information*
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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