Helen Ayles

This is heartbreaking- not only for the cuts but also that the systems are clearly not working to get people on treatment in the govt clinics which are still working. Zambia does have ART still available in stock and so people can continue their ART…. But as always the health system is kafkaesque….

Fascinating session with great talks from Vietnam, Nigeria and Thaïland. POC CRP could easily be deployed but why isn’t it?

#WorldTBDay tomorrow, don't miss our joint WTBD Symposium with @ucltb.bsky.social You may still be able to join us in person www.eventbrite.co.uk/e/world-tb-d... or if not, online. It's going to be an amazing event!
#WTBD2025
#Commit
#Invest
#Deliver

Yes I think more from Zambia moving and also more discussions on LinkedIn?

Trump and Co are giving the term "structural violence" a whole new meaning

Fascism: I sometimes fear... I sometimes fear that people think that fascism arrives in fancy dress worn by grotesques and monsters as played out in endless re-runs of the Nazis. Fascism arrives as your friend. It will restore your honour, make you feel proud, protect your house, give you a job, clean up the neighbourhood, remind you of how great you once were, clear out the venal and the corrupt, remove anything you feel is unlike you... It doesn't walk in saying, "Our programme means militias, mass imprisonments, transportations, war and persecution."

This by Michael Rosen is terrifying and apt for the times we live in now.

The new world order is exactly what it looks like. Are we too frozen with fear to name it? | Zoe Williams The truth is paralysing. But after JD Vance met the far-right leader Alice Weidel in Germany, it is time to be clear about what we are seeing, writes Zoe Williams

This excellent piece alerted me to the poem.

READ THIS: Clinical trials versus the real world in tuberculosis control

Editorial from @thelancet.bsky.social Infectious Diseases. Could not agree more with many of the challenges outlined here in relation to clinical trials.

https://buff.ly/4i8LJ0d

Hi I’m Helen Ayles. ID physician and epidemiologist living and working in Zambia for 27 years now. Passionate about TB/HIV, proud “randomista”. Work at Zambart ( need to get them on here), employed by LSHTM and still hold honorary NHS contract in Brighton, UK

% of participants diagnosed with TB within 72 hours was 15.3% in control arm compared to 16% in intervention arm

Figure shows intervention involving testing sputum, urine and stool. Control arm is WHO standard

#UnionConf2024 Disappointing results from EXULTANT trial which found no increase in TB diagnosed with universal sputum, urine (Xpert &LAM) and stool Xpert compared to standard algorithm in hospitalized patients with HIV. Most were symptomatic so absolute benefit only 4% extra (powered for 7%)

#UnionConf2024 intriguing talk on serum LAM with some promising results. Very small numbers and no details on what the test complexity will be but watch this space…..

William Bishai gave a very good explanation from mice which had both XX and XY in gonadally male and female. It seemed that it was mostly down to gonadal sex rather than chromosomes but that is a gross simplification on my part! But recommend watching if you can!

#UnionConf2024 Fascinating talk by Arjan Van Laarhoven showing possible different endotypes in TB meningitis which could suggest individualised treatment needed to reduce mortality

Can an electronic stethoscope with AI predict disease severity? Seems that there is an interesting initial signal that needs further testing out…. #UnionConf2024

#UnionConf2024 great sessions in TBScience🧪this morning on heterogeneity in TB. Why are men more susceptible? Does ancestry play a role? And who resists infection?

It’s time for access for all. #UnionConf2024

#UnionConf2024 Why are 1.3m people still dying of TB? Despite increasing access to TB drugs we need to do more. Lots of wins getting drug prices down but battles take time and effort- people die waiting!
Great talk by Christopher Perrin
#IDsky #GHsky #TBsky 🧪🛟😷🩺

Please add me- TB diehard living in Zambia

Hi Madhu and all, I’m a clinic Cain and epidemiologist working on TB and HIV- but also other stuff, living and working in Zambia for several decades

Lots of discussion on phase 3 TB vaccine trials at #UnionConf2024. We desperately need more trial sites but hearing stories of sites/countries feeling abused by sponsors as delays in site initiation/IP and competitive recruitment mean “less favored” sites likely to end up out of pocket.

Yes am here- 👋 trying to post and need to find TB folk out there #TBsky!! #UnionConf2024

At #UnionConf2024 at StopTB (are they on Balt?) New tools meeting. Great to hear Indonesia planning for TB vaccines- roll out and manufacturing plans….💪🧪🛟🩺😷

So am at #Unionconf2024 in Bali Indonesia. Will try to post highlights. Anyone else on blusky here? Union and TB world seem to be behind and still on X……🙄

Interesting and I note other studies with different immunomodulatory agents are awaited. Is there enough data to get a dose effect? Some patients received longer courses than others?

This is my go to every year. Really simple,delicious and very forgiving of substitutions for ingredients you don’t have!!!

Yes…. Largely obsolete now but there is a story in there as well about medical journal bias which has delayed publication….

Evaluation of hydroxychloroquine or chloroquine for the prevention of COVID-19 (COPCOV): A double-blind, randomised, placebo-controlled trial In a randomised controlled trial, William Schilling and co-workers investigate potential prevention of COVID-19 by chloroquine or hydroxychloroquine.

So in the early days of COVID, pre vaccines, Zambart took part in COPCOV- a trial of chloroquine/ hydroxychloroquine as prevention. I know you all think you know the answers but here is the paper journals.plos.org/plosmedicine.... Read it before you comment…..
🧪 #ID

So glad to find you here Larry- was worried that I would miss you from the other place…..

Me too. Hoping some others will also follow

Rich countries never learn lessons from history. Doing the “right thing” is not only right for others but will pay rewards for them in the future. Long term we need to ensure Africa can make our own vaccines and not rely on hand-outs