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Scientific Highlights: Thursday 31 October

31 Oct 2019

The Union World Conference brings the latest research on all aspects of tuberculosis (TB) and lung disease to a world stage. The first day of scientific sessions began today, Thursday 31 October, and presented on a range of topics – some highlights are summarised here below.

STUDY URGES MORE FOCUSED APPROACH IN DETECTING TB

Defining novel TB risk groups for intensified case-finding based on state-level case detection gaps in Nigeria.

A new study has shown that active case finding of TB can be improved by focusing on area-specific data.

The findings suggest that intensified case-finding activities should target groups informed by detection gaps and that national TB programmes may benefit by developing targeted strategies rather than taking a generalised ‘one size fits all’ approach.

The study took place in Nigeria which has the lowest TB case detection rate among high TB burden countries and faces significant resource constraints. The study analysed data to identify if case detection gaps related to any specific groups and found that missing cases in Nigeria differ depending on geographic area. In South West Nigeria gaps were largest among males and ages 45-54 years while in South East Nigeria, gaps were largest among ages 15-24 years but similar by sex.

STUDY POINTS TO URGENT NEED FOR FOCUS ON CHILD AND ADOLESCENT TB

Profiling Mycobacterium tuberculosis transmission and the resulting disease burden in the five highest tuberculosis burden countries

Adolescents and young adults are disproportionately driving TB transmission a new study has found.

Relying only on the observed distribution of disease to understand the age-profile of transmission is potentially misleading and is hampering control efforts, according to the study.

The research took place across the five highest TB burden countries and estimates that 15-19-year-olds are responsible for more than 20 percent of transmission events in India, the Philippines and Pakistan, despite representing only 5 percent of TB cases. The incidents of childhood TB are also disproportionate in these countries and are significantly higher those observed from notification data.

NEW ANALYSIS MODEL SHOWS FOLLOW UP TB TREATMENT CAN SAVE MONEY AND REDUCE TRANSMISSION

Cost-effectiveness of post-treatment follow-up and secondary prevention of tuberculosis in a high-incidence setting – a model-based analysis

Offering follow-up examinations and secondary preventive therapy to TB patients can cut the high costs involved in TB care and treatment a new method for modelling cost effectiveness has found.

In high-incidence settings, post-treatment follow-up and secondary preventive therapy can not only accelerate declines in TB incidence but can also potentially save resources for TB control.

The analysis says that implementing these strategies should be considered given their potential to accelerate declines in TB incidence in settings most severely affected by the disease.

A dynamic mathematical model was calibrated to data from a setting of approximately 40,000 people with an estimated TB incidence exceeding 1.0 percent in suburban Cape Town, South Africa. The model was used to look at interventions limited to the first year versus those which extended beyond the first year, post treatment.

FIRST GLOBAL ESTIMATE OF COPD BURDEN SHOWS IT IS ON THE RISE

The Prevalence and Attributable Health Burden of Chronic Respiratory Diseases from 1990-2017: A systematic analysis from the Global Burden of Disease Study 2017

A new study has revealed that chronic respiratory diseases (CRD’s) remain a leading and growing cause of death and disability worldwide.

Deaths from CRD’s increased by over 17 percent between 1990 and 2017, according to the study – which is the first to have examined the global burden of CRDs and their trends over time. It reveals that premature mortality from CRD is highest in regions with less-resourced health systems on a per-capita basis.

STATE OF THE ART TECHNOLOGY AT THE FOREFRONT OF BATTLE AGAINST TB

Optimizing parsimonious gene signatures defining the spectrum of tuberculosis infection

Ground breaking nanotechnology is helping to predict TB disease progression with a view to giving patients the most appropriate, targeted treatment.

Previous technology has been able to predict separate areas of disease outcomes but the PTB107 profiler can now examine multiple TB-related pathways simultaneously, including comorbidities such as diabetes, malnutrition and pregnancy, which is something that has not been possible before. The results can then be used to efficiently profile TB outcomes, crucially identifying people at higher risk of developing the disease.

Further developments using this type of technology are ongoing and continue to yield potentially exciting breakthroughs in TB outcomes.

 Note: Summaries are based on abstracts – final data presented at the conference may change

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