19 October-1 December 2020
The 51st Union World Conference On Lung Health
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Channel 4
SP-38-Hidden, but for how much longer? The epidemiological and economic burden of post-TB
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query_builder 16:30 - 17:50 | Event time (GMT+2)
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SP-38-Hidden, but for how much longer? The epidemiological and economic burden of post-TB
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Tuberculosis (TB) sequelae are likely among the most important causes of chronic lung disease globally, but we know little about the health and economic impact of TB after treatment completion. This multidisciplinary session aims to summarise novel research estimating the health and economic burden borne by TB survivors, followed by a facilitated panel discussion to stimulate conversation on what analytical, data and policy issues remain. The session starts at the bedside, describing the clinical characteristics of post-TB lung disease, before taking a macro perspective to estimate the number of TB survivors worldwide and the morbidity, mortality and economic burden of post-TB.

16:30 - 16:35: Introduction

16:35 - 16:45: Post-TB lung disease at the bedsideThis talk will begin with the definition of post-tuberculosis lung disease (PTLD), highlighting the strengths and limitations of the currently proposed definition. It will then describe a clinical classification of PTLD and explain areas of complexity, which can hamper measurement of PTLD, using single instruments (e.g. spirometry alone). The talk will use case studies of patients with PTLD as illustrations suitable for both non-clinicians and clinicians not familiar with the management of PTLD. Difficulties in clinical management of such patients will be briefly mentioned.
Brian Allwood

16:45 - 16:55: How many TB survivors are there alive today?We estimate the number of people alive in 2020 who have survived tuberculosis (TB) since 1980. We focus on those who have received treatment for TB (including restricting to those who have received treatment within the last five years), but also estimate the number of survivors whose TB went untreated. We report results by age, sex and HIV status at the World Health Organization (WHO) regional level and global level. To do this, we created post-TB life-tables by adapting UN life tables for each country and sex to single calendar years and ages, separating out HIV-specific mortality and applying hazard ratios for increased mortality among TB survivors. We applied these life-tables to interpolated WHO data on new TB notifications accounting for deaths on treatment. To estimate the number of survivors of untreated TB, we applied our post-TB life-tables and TB case fatality rates to WHO estimates of the gap between notifications and incidence.
Pete Dodd

16:55 - 17:05: Estimating the global morbidity and mortality burden of post-TBEstimates of the global burden of tuberculosis (TB) have focused on the morbidity associated with prevalent TB disease and the years of life lost due to death during the disease episode. In this analysis we estimate the additional burden of disease (years of life lived with disability, years of life lost and disability adjusted life years) resulting from post-TB. We estimated these outcomes for the cohort of individuals that developed TB disease in 2018, as compared to a counterfactual of no TB disease. We estimated outcomes using a mechanistic model that simulated health outcomes over the lifetime, stratified by age, sex, HIV status and multidrug-resistant TB status. We report results by country and regional groupings. Post-TB represents a substantial additional burden of disease caused by TB. These results provide additional motivations for TB prevention and for limiting the accumulation of lung damage and other morbidity for those who do develop disease.
Nicolas Menzies

17:05 - 17:15: Estimating the economic burden of post-TB to the householdReduction of catastrophic costs due to tuberculosis (TB) is a key policy priority globally, but estimates of catastrophic cost currently assume costs are only incurred during the disease episode. In this analysis we estimate patient and household-incurred costs due to post-TB. We describe a framework of post-TB costs incurred by households, including direct medical, direct non-medial and indirect costs. We estimate costs incurred to households for the cohort of individuals that developed TB disease in 2018 in selected countries. We describe preliminary estimates of costs and catastrophic costs incurred by TB-affected households across countries and by category.
Sedona Sweeney

17:15 - 17:25: Hidden, but for how much longer? Synthesising the next steps for post-TB researchIn the final part of this session, we will first synthesise key points raised by panelists and identify key areas of similarity and difference across presentations. Then, we will facilitate a panel discussion to identify important areas for future work to identify what analytical, data and policy issues remain.
Matthew Quaife

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

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Channel 2
OA-40-Health and well-being post-TB
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query_builder 15:00 - 16:20 | Event time (GMT+2)
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OA-40-Health and well-being post-TB
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15:00 - 15:05: Introduction


15:05 - 15:13: OA-40-742-24-Comorbidities and all-cause mortality post-TB treatment: a retrospective cohort study of patients previously treated with second line TB drugs in Georgia Emerging evidence suggests that patients formerly treated for tuberculosis (TB) are likely to be at increased risk of morbidity and mortality post-TB. Our study found that post-TB mortality rates were higher among TB survivors with pre-existing comorbidities, including hyperglycemia (i.e.diabetes/pre-diabetes), hepatitis C virus, and human immunodeficiency virus (HIV) co-infection.

Argita Salindri

15:13 - 15:21: OA-40-743-24-TB Sequel project: characteristics of a TB cohort at treatment initiation in four African countries Tuberculosis (TB) is a global health emergency with little known about the long-term sequelae. The TB Sequel cohort aims to describe lung outcomes in African patients. This abstract presents the description of the characteristics of TB patients enroled into the study.

Andrea Rachow

15:21 - 15:29: OA-40-744-24-Lung function post-TB in Malawian adults: a three-year cohort study We followed-up patients three years from complication of tuberculosis (TB) treatment and reviewed patient outcomes including lung function, healthcare-seeking, symptoms and clinical observation. We concluded that, for a subset of the population, post-TB lung disease is a significant consequence of pulmonary TB.


Rebecca Nightingale

15:29 - 15:37: OA-40-745-24-Risk factors associated with recurrent TB: a systematic review and meta-analysis Recurrent tuberculosis (TB) frequency and proportion of re-infections and relapses, vary in different settings. We performed a systematic review and meta-analysis of risk factors associated to recurrent TB, relapses and reinfections among literature since 1980. 

Victor Vega

15:37 - 15:45: OA-40-746-24-Systematic review and meta-analysis of the association between recurrent TB and HIV infection Tuberculosis (TB) patients with HIV infection may be at a higher risk of recurrent TB than HIV-negative ones. We aimed to review the frequency of recurrent TB and the risk of developing recurrent TB, exogenous reinfection and relapse, according to HIV status among literature since 1980.

Victor Vega

15:45 - 16:20: Q&A


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