James Seddon

Tuberculosis and undernutrition: improving estimates to reinforce the policy imperative Undernutrition is a key driver of the global tuberculosis epidemic, increasing the risk of people developing tuberculosis disease and of poor outcomes in those who do.1 Each year, WHO publishes estima...

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Tuberculosis and undernutrition: improving estimates to reinforce the policy imperative

www.thelancet.com/journals/lan...

Great to see this published after the hard work in Stockholm and Cape Town! How should we think about aerosol detection of #tuberculosis? Is it a diagnostic test? Could it help us prioritize prevention activities? Much more work to do, but exciting nonetheless @climeresearchgroup.bsky.social @ki.se

Global, regional, and national estimates of tuberculosis incidence averted by eliminating undernutrition in adults: a modelling study Background Current efforts to reduce global tuberculosis incidence have proved insufficient, highlighting that urgent action is needed to address underlying modifiable risk factors such as undernutrit...

So...what would happen to the global TB epidemic if we hypothetically "eliminated" undernutrition? In this preprint, we combined estimates from our new review (doi.org/10.1093/ije/...) with population-specific BMI distributions to find out...(doi.org/10.1101/2025...)

Computer-aided reading of chest radiographs for paediatric tuberculosis: current status and future directions Computer-aided detection (CAD) systems for automated reading of chest x-rays (CXRs) have been developed and approved for tuberculosis triage in adults but not in children. However, CXR is frequently t...

Although several AI algorithms can interpret chest x-rays for TB, we still do not have validated or approved CAD products for children. With @jaseddon.bsky.social and colleagues, we shared our thoughts on how to advance CAD for #pediatricTB:

www.thelancet.com/journals/lan...

#tbsky #idsky

A clinical practice guideline for tuberculous meningitis Tuberculous meningitis is the most severe form of tuberculosis, causing death or disability in around half of those affected. There are no up-to-date international guidelines defining its optimal mana...

A clinical practice guideline for tuberculous meningitis

Tuberculous Meningitis International Research Consortium

www.thelancet.com/journals/lan... 🔒

Meet the antivax whisperer fighting the vaccine slump Professor Elizabeth Whittaker convinces reluctant parents to get their children jabbed — and has seen the horrors that unchecked diseases like measles inflict

Meet the antivax whisperer trying to turnaround Britain's child vaccine slump one family at a time. How does she do it? What does she say?

Interview with Professor Elizabeth Whittaker:
www.thetimes.com/article/26a8...

Impact of puberty on immune responses to Mycobacterium tuberculosis in South African adolescents As individuals progress through adolescence, their risk of tuberculosis (TB) increases and the type of disease that develops changes, with increasing cavitary formation and parenchymal tissue destruction.

Impact of puberty on immune responses to Mycobacterium tuberculosis in South African adolescents

✅ Just Accepted
#IDSky

Management of individuals exposed to multidrug-resistant or rifampicin-resistant tuberculosis Individuals exposed to a person with infectious multidrug-resistant or rifampicin-resistant (MDR-RR) tuberculosis are at risk of developing tuberculosis disease. Historically, insufficient empirical e...

Loads of amazing colleagues have contributed to this review of the management of individuals exposed to MDR/RR-TB. www.thelancet.com/journals/lan...

Impact of puberty on immune responses to Mycobacterium tuberculosis in South African adolescents AbstractBackground. As individuals progress through adolescence, their risk of tuberculosis (TB) increases and the type of disease that develops changes, w

TB seems to comprehensively disrupt the normal physiological progression of puberty.

academic.oup.com/jid/advance-...

Risk of tuberculosis infection in young children exposed to multidrug-resistant tuberculosis in the TB-CHAMP multi-site randomised controlled trial Young children have a high risk of developing tuberculosis (TB) disease following infection with Mycobacterium tuberculosis in the absence of preventive treatment.

Risk of tuberculosis infection in young children exposed to multidrug-resistant tuberculosis in the TB-CHAMP multi-site randomised controlled trial

✅ Just Accepted
#IDSky

Brilliant work by @cfmcquaid.bsky.social and Matt Saunders!

Their updated analysis— a MOUNTAIN of work— shows that an increase in 1 unit of BMI reduces TB risk by 12.3%.

@theunion-tblh.bsky.social @jasonandrews.bsky.social @madhupai.bsky.social

Link: papers.ssrn.com/sol3/papers....

The New England Journal of Medicine Oral Regimens for Rifampin-Resistant Tuberculosis A PLAIN LANGUAGE SUMMARY Visual representation of a patient with rifampin-resistant tuberculosis. Read the full Plain Language Summary at NEJM.org.

In the endTB trial, researchers assessed the efficacy and safety of five 9-month, all-oral treatment regimens, as compared with the evolving standard of care, in participants with rifampin-resistant, fluoroquinolone-susceptible tuberculosis. nej.md/3WFFJTv

#MedSky #IDSky

Interesting paper published today in Chest, led by Cheng Chen and Leo Martinez. High frequency of reversions observed when serial QTF is performed. Reversion rates decreased with time from exposure and at older ages. Data from 4 different countries

@chest

linkinghub.elsevier.com/retrieve/pii...

Oral Regimens for Rifampin-Resistant, Fluoroquinolone-Susceptible Tuberculosis | NEJM For decades, poor treatment options and low-quality evidence plagued care for patients with rifampin-resistant tuberculosis. The advent of new drugs to treat tuberculosis and enhanced funding now p...

Proud to see the endTB trial, work of a huge team, led by @partnersinhealth.bsky.social, @msf.org, IRD & supported by @unitaid.bsky.social, published in @nejm.org today. Safe, effective, shortened treatments for drug-resistant TB can be available to all. #TBSky #ForeignAid tinyurl.com/NEJM-endTB

Global burden of tuberculous meningitis in children aged 0–14 years in 2019: a mathematical modelling study Tuberculous meningitis is fatal if untreated and can lead to lifelong neurological sequelae. However, to our knowledge, there are no data on the numbe…

Happy to have been part of the mammoth team effort reviewing and modelling the burden of TBM in children #TBsky www.sciencedirect.com/science/arti...

A Meta-Analysis of Levofloxacin for Contacts of Multidrug-Resistant Tuberculosis Data from randomized trials evaluating the effectiveness of tuberculosis (TB) preventive treatment for contacts of multidrug-resistant (MDR)-TB are lacking. Two recently published randomized trials...

Nice to see VQUIN and TB-CHAMP finally out. Both studies evaluated levofloxacin (compared w/placebo) as preventive treatment for MDR TB contacts.
Meta-analysis showed 60% reduction: evidence.nejm.org/doi/full/10....
Each study:
www.nejm.org/doi/full/10....
www.nejm.org/doi/full/10....

Thanks Patrick. All a bit unclear. Probably a combination of better diagnostics in adults meaning that children less exposed, and really thorough screening at baseline to exclude any hint of early disease. I think that some of the efficacy seen in most TPT trials is in treating early disease.

Thanks Tom. I suspect that the better you make the baseline screening, the less effective the TPT becomes as you identify and exclude very early disease which is probably what most TPT is treating. But yes, for me, I will give levofloxacin to children <5 years exposed to MDR-TB. Adults, hmmm.

And finally the meta-analysis of the two trials in NEJM Evidence with a nice article on the world's weird obsession with P values.

evidence.nejm.org/doi/full/10....
evidence.nejm.org/doi/full/10....

Also out in this issue of NEJM. Results from the VQUIN trial. www.nejm.org/doi/full/10....

This journey began for me in 2009. Beyond excited to see this now out in print. Thank you to everyone (a very large cast) who made this happen. www.nejm.org/doi/full/10....

TACTIC: Test, Avoid, Cure TB in Children Survey of adoption of WHO paediatric TB guidelines into national policy frameworks in 14 countries

A reminder on #WorldChildrensDay that 1.3million children fell ill with #tuberculosis in 2023, causing 200,000 paediatric deaths from a disease that's curable & preventable.

Govts & funders must urgently prioritise children in research funding & program implementation. msfaccess.org/tactic-test-...