19 October-30 November 2020
The 51st Union World Conference On Lung Health
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E-posters
EP10-Overcoming barriers in the contact cascade of care
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EP10-Overcoming barriers in the contact cascade of care
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

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

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

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

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

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

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

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

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

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

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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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Channel 2
OA-02-Finding a needle in the haystack: where are children with TB?
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OA-02-Finding a needle in the haystack: where are children with TB?
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11:00 - 11:05: Introduction


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

Oluremilekun Kusimo

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

Rose Otieno-Masaba

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

Yeonsoo Baik

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

Lise Denoeud-Ndam

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

Dylan Peterson

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

Jean-Francois Lemaire

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

Susan Purchase

12:01 - 12:20: Q&A


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Channel 3
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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SP-09-Ending TB in vulnerable populations through operational research, capacity building and evidence-informed decision making in Eastern Europe and Central Asia (Find-Treat-All).
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SP-09-Ending TB in vulnerable populations through operational research, capacity building and evidence-informed decision making in Eastern Europe and Central Asia (Find-Treat-All).
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The objective is to present new evidence on optimised case finding, use of digital technology for TB diagnosis and care, and adjunctive interventions in complex cases for key populations in Eastern Europe and Central Asia (EECA). The evidence was generated from EECA researchers under the Structured Operational Research and Training Initiative (SORT IT), which is a global partnership coordinated by the TDR, The Special Programme for Research and Training in Tropical Diseases. The specific SORT IT programme that led to this symposium was implemented by Tuberculosis Research and Prevention Center, Armenia, the Alliance for Public Health, Ukraine, The Union and TDR.

15:00 - 15:05: Introduction

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

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

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

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

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

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

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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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EP19-Quality and modelling of TB
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EP19-Quality and modelling of TB
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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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