19 October-1 December 2020
The 51st Union World Conference On Lung Health
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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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OA-10-Partnerships for integrating services
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OA-10-Partnerships for integrating services
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11:00 - 11:05: Introduction


11:05 - 11:13: OA-10-556-22-Engaging private healthcare providers to intensify TB case detection Private healthcare providers play a key role in tuberculosis (TB) referral, diagnosis and treatment. Engaging them effectively can help to close the TB notification gap and ensure that patients receive proper TB care.

Rajesh Sah

11:13 - 11:21: OA-10-557-22-Rational medicine use when presented with TB symptoms: private sector prescribing practices in two urban regions of South Africa Are South African patients with tuberculosis (TB) and TB-HIV, who present to the private sector, diagnosed efficiently and effectively? Do they receive care that is of an acceptable cost to them and their community? We explore prescribing practices of private GPs and the potential contributors to TB diagnostic delay and antimicrobial drug resistance.

Angela Salomon

11:21 - 11:29: OA-10-558-22-Engaging informal providers to screen and refer TB presumptive cases for formal TB diagnosis: use of barcode sticker system to refer TB presumptives The Clinton Health Access Initiative (CHAI) and the national TB programme developed a systematic package of actively engaging traditional healers, pharmacies and drug stores to actively screen, refer and follow up TB presumptives for formal TB diagnosis at the facility in two districts in Malawi. It demonstrated the potential to increase TB notifications.

Godwin Nyirenda

11:29 - 11:37: OA-10-559-22-Integrating services of TB, HIV/AIDS and malaria at the community level: lessons from community systems', strengthening pilot project in Kenya Delivering  health services for each condition separately, contributes to fragmented service delivery at the community level. This abstract is about assessing the possibility of integrating services for tuberculosis, HIV/AIDS and malaria at the community level, and monitoring if there was improvement in performance of the health indicators.

Paul Maleya

11:37 - 11:45: OA-10-560-22-Adherence to TB screening and treatment initiation guidelines in urban Nigeria: a study of TB care quality among private clinical providers in two states A study of private clinical providers’ management of presumptive and confirmed TB patients in urban Nigeria - using standardised patient and vignette survey methodology - reveals a minority of providers were able to demonstrate fully correct case management. Bottlenecks to correct management include provision, or referral, for diagnostics and counselling for confirmed patients.

Lauren Rosapep

11:45 - 11:53: OA-10-561-22-Provider-initiated active TB case finding in high volume, healthcare facilities: preliminary results from an ongoing project in Nigeria KNCV Nigeria's active tuberculosis (TB) case finding project, which is funded by the United States Agency for International Development, introduced provider–initiated TB case finding in health facilities. Designated screening officers and facility staff were trained on the use of a symptom checklist for TB screening in order to identify presumptive TB, linkage for diagnostic evaluation and treatment for confirmed TB cases.

Ogoamaka Chukwuogo

11:53 - 12:01: OA-10-562-22-Significant boost needed to ensure sustainable procurement by governments of WHO-recommended TB medicines in high burden countries while shifting from donor-supported to domestically-funded procurement While countries are increasingly required to purchase tuberculosis (TB) medicines with domestic funds, access to all World Health Organization (WHO) recommended TB medicines is not secured. Local registration of at least one source meeting WHO quality standards, up-to-date nEMLs, transparent national tenders. More focused technical assistance from donors and WHO is urgently required.

Christophe Perrin

12:01 - 12:20: Q&A


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OA-18-(Im)possible mission: TB care in low-resourced settings
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OA-18-(Im)possible mission: TB care in low-resourced settings
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15:00 - 15:05: Introduction


15:05 - 15:13: OA-18-612-22-Enabling MPs to support and take ownership of India’s TB programme Localised review and troubleshooting mechanisms, with political will and ownership driving them forward, could be pivotal for the success of tuberculosis (TB) programmes. This pilot initiative showed that elected representatives (Members of Parliament), when provided with the right tools and information, are well placed to support TB elimination efforts. 

Indira Behara

15:13 - 15:21: OA-18-613-22-99DOTS for TB treatment supervision in Uganda: adherence rates and acceptability 99DOTS is a low-cost technology with the potential to improve tuberculosis (TB) treatment adherence and completion. We implemented 99DOTS at 18 health facilities in Uganda to evaluate treatment adherence, benefits and challenges of using it. Despite challenges of phone availability and software malfunctions, patients and providers found the technology acceptable and convenient.

Alex Kityamuwesi

15:21 - 15:29: OA-18-614-22-Determinants of delayed diagnosis and treatment of TB in high burden countries: a mixed methods systematic review and meta-analysis Delays in diagnosis and treatment vary across countries and little is known among countries bearing most of the global tuberculosis (TB) burden. Therefore, a systematic review and meta-analysis were undertaken to derive the determinants and duration of diagnosis and treatment delay of pulmonary TB in the high TB-burden countries.

Alvin Kuo Jing Teo

15:29 - 15:37: OA-18-615-22-The effect of depression, anxiety and other risk factors on adherence to anti-TB treatment in the Philippines It is important to know the effect of depression, anxiety, stigma, social/family support and nutrition on adherence. In the Philippines, there is limited published research on the barriers to adherence in tuberculosis (TB) patients. This study investigated the reasons for non-adherence among Filipino TB patients enrolled in public TB-DOTS centres. 

Hend Elsayed

15:37 - 15:45: OA-18-616-22-Impact of HIV 'test and treat' policy on the incidence of TB in HIV populations in East-Central Uganda This abstract demonstrates the impact of the test and treat early antiretroviral treatment initiation policy on the incidence of tuberculosis (TB) among HIV populations, in programme settings in sub-Saharan Africa. The risk of TB among people living with HIV significantly reduced with the test and treat policy. It adds programmatic evidence for the implementation of the policy.

Rodrigo Nyinoburyo

15:45 - 15:53: OA-18-617-22-Utility and benefits of TB molecular bacterial load assay to monitor TB therapy in a resource-limited, high burden setting Rapid and accurate tests are needed for monitoring tuberculosis (TB) therapy. We explored the utility and benefits of TB molecular bacterial load assay (TB-MBLA) for monitoring TB therapy. We found that the TB-MBLA test provides rapid and accurate results in time to inform clinical management of TB patients and that it can be applied in high burden settings.

Bariki Mtafya

15:53 - 16:01: OA-18-618-22-Using TB care process mapping to improve treatment retention and treatment success rate in low-income settings: experience from central Uganda According to the World Health Organization, tuberculosis (TB) treatment success rate (TSR) is below the 95% global target in many countries, including in Uganda. TB patient retention is a contributor to TSR. By early 2019, only 17% facilities were meeting the national retention target. A TB care process mapping intervention was implemented with improvements in retention and TSR.  

Herbert Kisamba

16:01 - 16:20: Q&A


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Channel 2
OA-23-TB: finding the missing millions
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OA-23-TB: finding the missing millions
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11:00 - 11:05: Introduction


11:05 - 11:13: OA-23-640-23-Improving detection of persons with TB during national polio immunisation plus days and polio outbreak response activities in Kaduna State, Nigeria Nigeria remains among the high burden tuberculosis (TB), TB-HIV and drug-resistant TB countries. Leveraging on the polio immunisation plus days (NIPD), where virtually every household in the state is visited by the house-to-house vaccination teams, presents an avenue for identifying the missing or un-diagnosed people with TB in the community.

Dauda Samuel Hananiya

11:13 - 11:21: OA-23-641-23-Results of active case finding with, and without, the joined approaches of the seed-and-recruit model We have shown that roving, one-off active case finding, along with a joint seed-and-recruit model, can have a significant impact on the number of people receiving tuberculosis (TB) treatment, even in the context of a well-functioning TB programme with declining notifications. We are very happy with the success of both projects generating high additionality.

Monyrath Chry

11:21 - 11:29: OA-23-642-23-Missing no more: improved case detection of childhood TB through active case finding in hard-to-reach riverine communities in southern Nigeria We report the results of a focused, community-wide project intervention in hard-to-reach riverine communities in southern Nigeria, and the corresponding impact on childhood tuberculosis case notification within the intervention period. Our findings highlight enablers that can improve TB case finding in resource-constrained settings.

Ngozi Murphy-Okpala

11:29 - 11:37: OA-23-643-23-Thinking outside the (TB) box: intensified paediatric TB case finding in non-TB entry points in nine sub-Saharan countries Paediatric tuberculosis (TB) is under-diagnosed, highlighting a need for effective case finding. We introduced systematic TB screening using a child-adapted, symptom-based tool in waiting areas of non-TB entry points across nine countries. We found low numbers needed to screen in order to diagnose one case in outpatient departments, paediatric wards and nutrition services.

Shirin Kakayeva

11:37 - 11:45: OA-23-644-23-Implementing structured TB screening as part of routine child care services at orphanage homes in a Nigerian local government area Five large orphanage homes were engaged to include regular tuberculosis (TB) screening as part of their routine care package for the children. Over a nine-month period, TB cases were diagnosed among the children and their caregivers. We recommend that periodic evaluation for TB be considered for all such settings.

Ukamaka Onyima

11:45 - 11:53: OA-23-645-23-Data-driven TB active case finding in South Kivu, Democratic Republic of the Congo, leveraging innovative predictive and surveillance reporting software applications We designed and tested a two-step methodology for the systematic screening of tuberculosis (TB) for active case findings. This encompasses the development of an incidence-rates prediction map at a very granular level and the usage of the Mediscout© applications for individual risk assessment. The pilot test in South Kivu showed promising results.

Mauro Faccin

11:53 - 12:01: OA-23-646-23-Finding missing patients: yield of targeted universal testing for TB in high-risk groups presenting to 30 primary healthcare facilities in South Africa We report yield of a risk factor-based testing strategy in South Africa. To be tested, clinic attendees had ≥1 tuberculosis (TB) risk factor; HIV infection; recent contact with a TB patient or recent prior TB, irrespective of symptoms of TB. Participants provided a single specimen for Xpert Ultra and MGIT culture.

Rebecca Berhanu

12:01 - 12:20: Q&A


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E-posters
EP31-Allied against TB: new and old partners
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EP31-Allied against TB: new and old partners
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All E-posters are accessible via the "E-posters" section of the conference platform until 30 November.

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

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

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

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

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

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

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

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

Vikas Panibatla

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

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

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