Rebecca Clark

Climate change and tuberculosis: an analytical framework Climate change is likely to exacerbate a range of determinants that drive tuberculosis, the world's leading cause of death from a single infectious agent. However, tuberculosis is often neglected in w...

Our framework that informed the @who.int TB & climate change policy brief out now in @lancetrespirmed.bsky.social, exploring the intersections and implications of climate change for the TB epidemic. Key message? TB should be considered a climate-sensitive disease
www.thelancet.com/journals/lan...

Announcement Awardees | TBVI Awards 2026 - TuBerculosis Vaccine Initiative Announcement Awardees | TBVI Awards 2026

✨ I’m so honoured to have been awarded one of this year’s TBVI Awards! ✨

I’m truly grateful for this recognition and excited for the opportunity to showcase my research at the TBVI Annual Meeting in January 2026.

#TBVI #tuberculosis #vaccines

tbvi.eu/announcement...

Body mass index and tuberculosis risk: an updated systematic literature review and dose–response meta-analysis AbstractBackground. The relationship between nutritional status and tuberculosis is critically important but poorly understood. We extended a 2009 review c

We think our recent review provides a better estimate of the RR leading to a much higher PAF, demonstrating the importance of addressing undernutrition to prevent TB.
academic.oup.com/ije/article/...

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...

“Wow, I saw in the last GTB report undernutrition is much less important for TB than we previously thought” I hear you say…
Well, no. We think this is an underestimate, & as much as 28% of TB could be attributable to undernutrition – see our latest comment here: www.thelancet.com/journals/lan...

Impact of fluoroquinolone resistance on the cost-effectiveness of empiric treatment for multidrug- or rifampicin-resistant tuberculosis The WHO recommends the bedaquiline, pretomanid, and linezolid (BPaL) regimen with the additional fluoroquinolone antibiotic moxifloxacin (BPaLM) for initial treatment of multidrug- or rifampicin-resis...

When fluoroquinolone resistance status is unknown, empirical use of BPaLM (adding moxifloxacin to BPaL) is cost-effective as a replacement for BPaL even with high fluoroquinolone resistance levels! 🦠💊

doi.org/10.1371/jour...

A global analysis of patterns of tuberculosis exposure and transmission Tuberculosis (TB) is a major public health concern and the leading infectious cause of mortality globally. The disease exhibits strong prevalence patterns by age and sex, but the implications of these...

Understanding patterns of #TB exposure and transmission is needed for targeted prevention strategies. In our latest pre-print, @petedodd24.bsky.social and I estimated the proportion of TB exposure to and transmission from sex and age groups for 177 countries.

bit.ly/4nbV492

1/ It’s been 10 years (😮) since we reported that #TB prevalence was twice as high in men as in women.

📢 Our new preprint explores how sex differences have shifted with more recent national prevalence surveys and growing attention to #gender responsive TB prevention and care.

bit.ly/4gqP1LH

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...)

Body mass index and tuberculosis risk: an updated systematic literature review and dose–response meta-analysis AbstractBackground. The relationship between nutritional status and tuberculosis is critically important but poorly understood. We extended a 2009 review c

Nutritional status is a key determinant of TB. In this updated systematic review and dose-response meta-analysis (43 cohorts inc > 26 million people) we redefined the relationship between body mass index (BMI) and TB. doi.org/10.1093/ije/...

The potential impact, cost and cost-effectiveness of tuberculosis interventions - a modelling exercise Background While a range of interventions exist for tuberculosis prevention, screening, diagnosis, and treatment, their potential population impact and cost-effectiveness are seldom directly compared,...

At a time when global resources for #TB research, development, prevention, and care are limited, which interventions should be prioritised in high burden settings?

📢 Our new pre-print compares the impact, cost, and cost-effectiveness of 9 TB interventions in 3 countries. 1/n

bit.ly/3V3vXth

Exploring trade-offs in diagnostic algorithm, population coverage, and duration of community screening for tuberculosis Background Current tuberculosis (TB) prevention and care strategies have failed to reduce disease burden at the pace required to meet global targets. Community screening may enable more rapid declines...

Community screening for #tuberculosis could extend the reach of #TB services, but evidence on its effectiveness is limited.

In our latest preprint, we examine the epidemiological impact of trade-offs in diagnostic algorithm, population coverage, and duration of screening. 1/n

bit.ly/3UK7pFD

Our new study examines social contact patterns in urban, peri-urban, and rural communities and their implications for #TB interventions like household contact tracing, infection prevention, and cluster RCTs. #MedSky #EpiSky #IDsky #TBSky

Read more in @plosglobalpublichealth.org

Reduced international donor funding through not only the termination of #USAID, but also announced reductions in donor pledges to #TheGlobalFund from other countries, could lead to substantial potential impacts on #TB morbidity and mortality.

Read how in our new study in @lancetgh.bsky.social 👇

Our work estimating the potential impacts of reductions in international donor funding for #TB is now out in @lancetgh.bsky.social:

bit.ly/3TDl28T

@raclark18.bsky.social @cfmcquaid.bsky.social @alexandra-richards.bsky.social @top-j.bsky.social @reinhouben.bsky.social @richardwhite321.bsky.social

New systematic review led by @hannahrickman.bsky.social shows annual risk of Mycobacterium #tuberculosis conversion in men and women diverges during adolescence and remains higher among men throughout adulthood.

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

Figure 1. Estimated number of trial endpoints in the control group of a prevention-of-disease vaccine trial in a high disease-burden setting showing number of endpoints on the y-axis and time in months on the x-axis. For bacteriologically confirmed symptomatic tuberculosis disease endpoints only, we estimate 69 endpoints, and for combined bacteriologically confirmed asymptomatic and symptomatic tuberculosis disease endpoints, we estimate 151 endpoints. Scenario assumes symptomatic disease incidence before trial screening of 300/100 000 per year and following 10 000 individuals over 3 years. Prevalent symptomatic and asymptomatic tuberculosis disease are screened out in month 0 and are not trial endpoints. Active screening occurs every 6 months for both scenarios and participants self-presenting with symptoms suggestive of tuberculosis disease would also be investigated.

In our latest personal view in @lancetrespirmed.bsky.social, we argue for the inclusion asymptomatic #tuberculosis in vaccine trial endpoints to potentially reduce the size, length, and cost of trials.

doi.org/10.1016/S221...

@lshtm-tbmod.bsky.social @tb-lshtm.bsky.social

Happening tomorrow! Come join us!

Tuberculosis and climate change: analytical framework and knowledge gaps This report explores the intersection of tuberculosis (TB) and climate change, highlighting how climate-related challenges such as food and water insecurity, displacement, and disrupted healthcare acc...

TB & climate change: @who.int report out now, building on an analytical framework we developed to explore the intersections and implications for the TB epidemic. Key message? TB should be considered a climate-sensitive disease www.who.int/publications...

25th anniversary celebrations of the Introduction to Infectious Disease Our special event will celebrate the 25th anniversary of the Introduction to Infectious Disease Modelling and its Applications course, delivered by the London School of Hygiene & Tropical Medicine

Can you believe it’s already been 25 years!?

Come join us on 20 June 2025 at 4pm UK time to celebrate the 25th anniversary of the Introduction to #Infectious Disease #Modelling course delivered by @lshtm.bsky.social and @ukhsa.bsky.social!

More info 👉 www.lshtm.ac.uk/newsevents/e...

Amid all the bad news in Global Health, perhaps some good news? A first analysis on the risk of false positive diagnoses in community-screening for tuberculosis using Xpert shows our clinic-based data is likely (very) wrong and overestimates false positives by >80%: tinyurl.com/yfecute9.

Postdoc (London, UK)
Position available in the world-leading tuberculosis (TB) Modelling group at LSHTM
with @raclark18.bsky.social‬ @richardwhite321.bsky.social
at LSHTM @lshtm-tbmod.bsky.social
More details: http://iddjobs.org/jobs/2314

Job Opportunity at LSHTM: Research Fellow The London School of Hygiene & Tropical Medicine (LSHTM) is a world-leading centre for research and postgraduate education in public and global health. Our mission is to is to improve health and healt...

Are you interested in #TB and have experience in #modelling infectious diseases?

Come join us in the TB Modelling Group at #LSHTM!

We're advertising for a 1 year Research Fellow position, with a closing date of 30 May 2025 👉 jobs.lshtm.ac.uk/vacancy.aspx...

🙋Interested in finding out about #vaccine hesitancy?💉

Join us for our Annual Lecture on Monday 19 May for an opportunity to hear from Prof Stephan Lewandowsky @bristolunipsych.bsky.social & network with colleagues @lshtm.bsky.social & the Vaccine Centre.🍹🤝

👉 www.lshtm.ac.uk/newsevents/e...

Our first #WorldImmunizationWeek podcast episode is live now!

Tune in to hear from @emprestige.bsky.social about their journey from MSc to PhD @lshtm.bsky.social. They also share insider tips on the best lunch spots in central London, so don't miss this.

soundcloud.com/user-7893872...

Table showing excess symptomatic TB episodes and excess TB deaths expected for different funding scenarios, including termination of USAID funding and reductions in Global Fund funding in line with expected reductions in donor countries' overseas development assistance.

Reductions in contributions to The Global Fund in line with current announcements by the United States, France, the United Kingdom, and Germany may lead to an additional 699,200, 63,100, 50,500, and 30,500 TB deaths, respectively. (See table for episodes of disease and other donor countries.) 4/8

The potential impact of reductions in international donor funding on tuberculosis in low- and middle-income countries Background Tuberculosis services in many settings rely heavily on international donor funding. In 2025, the United States Agency for International Development (USAID) was dismantled, and other countri...

#Tuberculosis prevention and care relies heavily on international donor funding in many settings. In our latest preprint, we examine the potential impact of reductions in international donor funding for #TB - by the US and by other major donor countries. 1/8

www.medrxiv.org/content/10.1...

Modelling projects the devastating impacts of US funding cuts, including our estimates of #TB incidence and deaths @lshtm-tbmod.bsky.social @tb-lshtm.bsky.social

🗓️ Coming up in May!

We are excited to welcome David Miles for our next seminar. This will cover a brief history of vaccinology, from Edward Jenner's first smallpox #vaccination to modern vaccine technology.

🗓️ 8 May
⏲️ 12.50 BST
📍LSHTM | Online
🔗 www.lshtm.ac.uk/newsevents/e...

Line chart showing median number of TB deaths in 79 low- and middle-income countries from 2010 through 2040. A black line shows a decline from 1.25 million deaths in 2010 to just under 1 million deaths in 2024. A blue line shows the number of deaths staying constant through 2040 if 2024 funding and programmes are maintained. A red line shows the number of deaths increasing to 1.2 million in 2040 if US funding to national TB programmes is terminated.

New pre-print modelling impact of US funding cuts on HIV, #TB, MCH and family planning. We estimate impact of termination of US funding to NTPs via #USAID & The Global Fund may lead to 2.2 (1.5-2.9) million excess TB deaths between 2025 and 2040, reversing over a decade of progress.

bit.ly/4lowp18

Tuberculosis and the climate crisis in Latin America: a predicament of poverty, migration and displacement Tuberculosis (TB) has long been associated with poverty and displacement, through food insecurity, overcrowding, poor living conditions and reduced access to healthcare, which significantly increase t...

Climate-driven migration and displacement and their potential impact on TB in Latin America gh.bmj.com/content/10/4... @cfmcquaid.bsky.social @reinhouben.bsky.social @lshtm-tbmod.bsky.social