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1. The prevalence of tuberculosis infection among foreign-born Canadians: a modelling study

Author

Jordan, Aria Ed, Houben, Rein M.G.J., Dodd, Peter J., Dale, Katie D., Trauer, James M., Denholm, Justin T., Johnston, James C., Khan, Faiz Ahmad, Campbell, Jonathon R., and Schwartzman, Kevin

Subjects
Medical research -- Health aspects, Medicine, Experimental -- Health aspects, Prevalence studies (Epidemiology) -- Health aspects, Tuberculosis -- Prevention, Rifamycins -- Health aspects, Health, World Health Organization
Abstract

Background: The prevalence of tuberculosis infection is critical to the design of tuberculosis prevention strategies, yet is unknown in Canada. We estimated the prevalence of tuberculosis infection among Canadian residents born abroad. Methods: We estimated the prevalence of tuberculosis infection by age and year of migration to Canada for people from each of 168 countries by constructing country-specific and calendar year-specific trends for annual risk of infection using a previously developed model. We combined country-specific prevalence estimates with Canadian Census data from 2001, 2006, 2011, 2016 and 2021 to estimate the overall prevalence of tuberculosis infection among foreign-born Canadian residents. Results: The estimated overall prevalence of tuberculosis infection among foreign-born people in Canada was 25% (95% uncertainty interval [UI] 20%35%) for census year 2001, 24% (95% UI 20%-33%) for 2006, 23% (95% UI 19%30%) for 2011, 22% (95% UI 19%-28%) for 2016 and 22% (95% UI 19%-27%) for 2021. The prevalence increased with age at migration and incidence of tuberculosis in the country of origin. In 2021, the estimated prevalence of infection among foreign-born residents was lowest in Quebec (19%, 95% UI 16%24%) and highest in Alberta (24%, 95% UI 21%-28%) and British Columbia (24%, 95% UI 20%-30%). Among all foreign-born Canadian residents with tuberculosis infection in 2021, we estimated that only 1 in 488 (95% UI 1851039) had become infected within the 2 preceding years. Interpretation: About 1 in 4 foreign-born Canadian residents has tuberculosis infection, but very few were infected within the 2 preceding years (the highest risk period for progression to tuberculosis disease). These data may inform future tuberculosis infection screening policies., Tuberculosis disease is the leading cause of death by a single infectious agent worldwide, surpassed only by COVID-19 in 2020 and 2021. (1) Tuberculosis disease is preceded by tuberculosis infection, [...]

Published
2023
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3. Classification of early tuberculosis states to guide research for improved care and prevention: an international Delphi consensus exercise

Author

Alland, David, Behr, Marcel A, Beko, Busisiwe B, Burhan, Erlina, Churchyard, Gavin, Cobelens, Frank, Denholm, Justin T, Dinkele, Ryan, Ellner, Jerrold J, Fatima, Razia, Haigh, Kate A, Hatherill, Mark, Horton, Katherine C, Kendall, Emily A, Khan, Palwasha Y, MacPherson, Peter, Malherbe, Stephanus T, Mave, Vidya, Mendelsohn, Simon C, Musvosvi, Munyaradzi, Nemes, Elisa, Penn-Nicholson, Adam, Ramamurthy, Dharanidharan, Rangaka, Molebogeng X, Sahu, Suvanand, Schwalb, Alvaro, Shah, Divya K, Sheerin, Dylan, Simon, Donald, Steyn, Adrie J C, Thu Anh, Nguyen, Walzl, Gerhard, Weller, Charlotte L, Williams, Caroline ML, Wong, Emily B, Wood, Robin, Xie, Yingda L, Yi, Siyan, Coussens, Anna K, Zaidi, Syed M A, Allwood, Brian W, Dewan, Puneet K, Gray, Glenda, Kohli, Mikashmi, Kredo, Tamara, Marais, Ben J, Marks, Guy B, Martinez, Leo, Ruhwald, Morten, Scriba, Thomas J, Seddon, James A, Tisile, Phumeza, Warner, Digby F, Wilkinson, Robert J, Esmail, Hanif, and Houben, Rein M G J

Published
2024
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5. Evaluating the equity impact and cost-effectiveness of digital adherence technologies with differentiated care to support tuberculosis treatment adherence in Ethiopia: protocol and analysis plan for the health economics component of a cluster randomised trial

Author

Foster, Nicola, Tadesse, Amare W., McQuaid, Christopher Finn, Gosce, Lara, Abdurhman, Tofik, Assefa, Demelash, Bedru, Ahmed, Houben, Rein M. G. J., van Kalmthout, Kristian, Letta, Taye, Mohammed, Zemedu, van Rest, Job, Umeta, Demekech G., Weldemichael, Gedion T., Yazew, Hiwot, Jerene, Degu, Quaife, Matthew, and Fielding, Katherine L.

Published
2023
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10. Concurrent evaluation of cytokines improves the accuracy of antibodies against Mycobacterium tuberculosis antigens in the diagnosis of active tuberculosis

Author

Walzl, Gerhard, Chegou, Novel N., Kriel, Magdalena, van der Spuy, Gian, Loxton, Andre G., Stanley, Kim, Malherbe, Stephanus T., Kriel, Belinda, Sutherland, Jayne S., Owolabi, Olumuyiwa, Sillah, Abdou, Mendy, Joseph, Gindeh, Awa, Donkor, Simon, Togun, Toyin, Ota, Martin, Crampin, Amelia C., Simukonda, Felanji, Amberbir, Alemayehu, Chilongo, Femia, Houben, Rein, Kassa, Desta, Gebrezgeabher, Atsbeha, Mesfin, Getnet, Belay, Yohannes, Gebremichael, Gebremedhin, Alemayehu, Yodit, van der Vyver, Marieta, Amutenya, Faustina N., Nelongo, Josefina N., Monye, Lidia, Sheehama, Jacob A., Iipinge, Scholastica, Mayanja-Kizza, Harriet, Namuganga, Anna Ritah, Muzanye, Grace, Nsereko, Mary, Peters, Pierre, Howe, Rawleigh, Mihret, Adane, Bekele, Yonas, Tessema, Bamlak, Yamuah, Lawrence, Ottenhoff, Tom H.M., Geluk, Annemieke, Franken, Kees, van der Ploeg-van Schip, Jolien J., Corstjens, Paul L.A.M., Tjon Kon Fat, Elisa M., de Dood, Claudia J., Rosenkrands, Ida, Aagaard, Claus, Kaufmann, Stefan H.E., Esterhuyse, Maria M., Cliff, Jacqueline M., Dockrell, Hazel M., Jacobs, Ruschca, Awoniyi, Dolapo O., Baumann, Ralf, McAnda, Shirley, Kaempfer, Susanne, and Singh, Mahavir

Published
2022
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11. Impact of active case finding for tuberculosis with mass chest X-ray screening in Glasgow, Scotland, 1950–1963: An epidemiological analysis of historical data.

Author

MacPherson, Peter, Stagg, Helen R., Schwalb, Alvaro, Henderson, Hazel, Taylor, Alice E., Burke, Rachael M., Rickman, Hannah M., Miller, Cecily, Houben, Rein M. G. J., Dodd, Peter J., and Corbett, Elizabeth L.

Abstract

Background: Community active case finding (ACF) for tuberculosis was widely implemented in Europe and North America between 1940 and 1970, when incidence was comparable to many present-day high-burden countries. Using an interrupted time series analysis, we analysed the effect of the 1957 Glasgow mass chest X-ray campaign to inform contemporary approaches to screening. Methods and findings: Case notifications for 1950 to 1963 were extracted from public health records and linked to demographic data. We fitted Bayesian multilevel regression models to estimate annual relative case notification rates (CNRs) during and after a mass screening intervention implemented over 5 weeks in 1957 compared to the counterfactual scenario where the intervention had not occurred. We additionally estimated case detection ratios and incidence. From 11 March 1957 to 12 April 1957, 714,915 people (622,349 of 819,301 [76.0%] resident adults ≥15 years) were screened with miniature chest X-ray; 2,369 (0.4%) were diagnosed with tuberculosis. Pre-intervention (1950 to 1956), pulmonary CNRs were declining at 2.3% per year from a CNR of 222/100,000 in 1950. With the intervention in 1957, there was a doubling in the pulmonary CNR (RR: 1.95, 95% uncertainty interval [UI] [1.81, 2.11]) and 35% decline in the year after (RR: 0.65, 95% UI [0.59, 0.71]). Post-intervention (1958 to 1963) annual rates of decline (5.4% per year) were greater (RR: 0.77, 95% UI [0.69, 0.85]), and there were an estimated 4,599 (95% UI [3,641, 5,683]) pulmonary case notifications averted due to the intervention. Effects were consistent across all city wards and notifications declined in young children (0 to 5 years) with the intervention. Limitations include the lack of data in historical reports on microbiological testing for tuberculosis, and uncertainty in contributory effects of other contemporaneous interventions including slum clearances, introduction of BCG vaccination programmes, and the ending of postwar food rationing. Conclusions: A single, rapid round of mass screening with chest X-ray (probably the largest ever conducted) likely resulted in a major and sustained reduction in tuberculosis case notifications. Synthesis of evidence from other historical tuberculosis screening programmes is needed to confirm findings from Glasgow and to provide insights into ongoing efforts to successfully implement ACF interventions in today's high tuberculosis burden countries and with new screening tools and technologies. Peter MacPherson and colleagues analyze public health records and demographics data using an interrupted time series approach to explore the effect of the 1957 Glasgow mass chest X-ray campaign for tuberculosis case finding. Author summary: Why was this study done?: Tuberculosis screening is conditionally recommended by the World Health Organization for populations with a high prevalence of disease or other structural risk factors. There is considerable uncertainty over the optimal approaches and population impact of tuberculosis screening. Between 1930 and 1970, mass screening for tuberculosis was widely undertaken, in Europe and North America, but there has been little attempt to understand what effect these programmes had on the trajectory of tuberculosis epidemics. What did the researchers do and find?: Over a 5-week period, in 1957, the city of Glasgow, Scotland implemented a tuberculosis screening programme comprising mass miniature X-ray of around 715,000 people supported by community mobilisation. Tuberculosis notification data and population demographics were extracted from city Medical Officer of Health reports between 1950 and 1963, and multilevel interrupted time series regression models were constructed to investigate the effect of the mass screening campaign on tuberculosis notifications, compared to the counterfactual scenario where the intervention had not occurred. Before the mass screening intervention (1950 to 1956), tuberculosis notification rates were declining at 2.3% per year, and rates doubled in the year of the intervention (1957). Post-intervention, tuberculosis notification rates declined at 5.4% per year, and there were an estimated 4,599 pulmonary notifications averted. Intervention effects were consistent across all 37 city wards, but showed differing effects by age group and sex. What do these findings mean?: A single, rapid, and high coverage round of mass tuberculosis screening, supported by intensive community mobilisation, likely had a major impact on changing the tuberculosis epidemiology trajectory in Glasgow. Greater understanding of how improved housing, social conditions, and tuberculosis care and prevention contributed to this screening effect is needed. Synthesis of evidence from other historical tuberculosis screening programmes is needed to confirm findings from Glasgow, and to support efforts to successfully implement active case finding (ACF) interventions in today's high tuberculosis burden countries and with new screening tools and technologies. [ABSTRACT FROM AUTHOR]

Published
2024
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14. Classification of early tuberculosis states to guide research for improved care and prevention: an international Delphi consensus exercise.

Author

Coussens, Anna K, Zaidi, Syed M A, Allwood, Brian W, Dewan, Puneet K, Gray, Glenda, Kohli, Mikashmi, Kredo, Tamara, Marais, Ben J, Marks, Guy B, Martinez, Leo, Ruhwald, Morten, Scriba, Thomas J, Seddon, James A, Tisile, Phumeza, Warner, Digby F, Wilkinson, Robert J, Esmail, Hanif, and Houben, Rein M G J

Subjects
DELPHI method, TUBERCULOSIS, MYCOBACTERIUM tuberculosis, EVIDENCE gaps, SYMPTOMS
Abstract

The current active–latent paradigm of tuberculosis largely neglects the documented spectrum of disease. Inconsistency with regard to definitions, terminology, and diagnostic criteria for different tuberculosis states has limited the progress in research and product development that are needed to achieve tuberculosis elimination. We aimed to develop a new framework of classification for tuberculosis that accommodates key disease states but is sufficiently simple to support pragmatic research and implementation. Through an international Delphi exercise that involved 71 participants representing a wide range of disciplines, sectors, income settings, and geographies, consensus was reached on a set of conceptual states, related terminology, and research gaps. The International Consensus for Early TB (ICE-TB) framework distinguishes disease from infection by the presence of macroscopic pathology and defines two subclinical and two clinical tuberculosis states on the basis of reported symptoms or signs of tuberculosis, further differentiated by likely infectiousness. The presence of viable Mycobacterium tuberculosis and an associated host response are prerequisites for all states of infection and disease. Our framework provides a clear direction for tuberculosis research, which will, in time, improve tuberculosis clinical care and elimination policies. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Routine childhood immunisation during the COVID-19 pandemic in Africa: a benefit–risk analysis of health benefits versus excess risk of SARS-CoV-2 infection

Author

Houben, Rein M G J, Edmunds, W John, Villabona-Arenas, Christian Julian, Atkins, Katherine E, Knight, Gwenan M, Sun, Fiona Yueqian, Auzenbergs, Megan, Rosello, Alicia, Klepac, Petra, Hellewell, Joel, Russell, Timothy W, Tully, Damien C, Emery, Jon C, Gibbs, Hamish P, Munday, James D, Quilty, Billy J, Diamond, Charlie, Pearson, Carl A B, Leclerc, Quentin J, Nightingale, Emily S, Liu, Yang, Endo, Akira, Deol, Arminder K, Kucharski, Adam J, Abbott, Sam, Jarvis, Christopher I, O'Reilly, Kathleen, Jombart, Thibaut, Gimma, Amy, Bosse, Nikos I, Prem, Kiesha, Hué, Stéphane, Davies, Nicholas G, Eggo, Rosalind M, Clifford, Samuel, Medley, Graham, Abbas, Kaja, Procter, Simon R, van Zandvoort, Kevin, Clark, Andrew, Funk, Sebastian, Mengistu, Tewodaj, Hogan, Dan, Dansereau, Emily, Jit, Mark, and Flasche, Stefan

Published
2020
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16. Effectiveness of isolation, testing, contact tracing, and physical distancing on reducing transmission of SARS-CoV-2 in different settings: a mathematical modelling study

Author

Emery, Jon C, Medley, Graham, Munday, James D, Russell, Timothy W, Leclerc, Quentin J, Diamond, Charlie, Procter, Simon R, Gimma, Amy, Sun, Fiona Yueqian, Gibbs, Hamish P, Rosello, Alicia, van Zandvoort, Kevin, Hué, Stéphane, Meakin, Sophie R, Deol, Arminder K, Knight, Gwen, Jombart, Thibaut, Foss, Anna M, Bosse, Nikos I, Atkins, Katherine E, Quilty, Billy J, Lowe, Rachel, Prem, Kiesha, Flasche, Stefan, Pearson, Carl A B, Houben, Rein M G J, Nightingale, Emily S, Endo, Akira, Tully, Damien C, Liu, Yang, Villabona-Arenas, Julian, O'Reilly, Kathleen, Funk, Sebastian, Eggo, Rosalind M, Jit, Mark, Rees, Eleanor M, Hellewell, Joel, Clifford, Samuel, Jarvis, Christopher I, Abbott, Sam, Auzenbergs, Megan, Davies, Nicholas G, Simons, David, Kucharski, Adam J, Klepac, Petra, Conlan, Andrew J K, Kissler, Stephen M, Tang, Maria L, Fry, Hannah, Gog, Julia R, and Edmunds, W John

Published
2020
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17. Global, regional, and national estimates of the population at increased risk of severe COVID-19 due to underlying health conditions in 2020: a modelling study

Author

Nightingale, Emily S, O'Reilly, Kathleen, Jombart, Thibaut, Edmunds, W John, Rosello, Alicia, Sun, Fiona Yueqian, Atkins, Katherine E, Bosse, Nikos I, Clifford, Samuel, Russell, Timothy W, Deol, Arminder K, Liu, Yang, Procter, Simon R, Leclerc, Quentin J, Medley, Graham, Knight, Gwen, Munday, James D, Kucharski, Adam J, Pearson, Carl A B, Klepac, Petra, Prem, Kiesha, Houben, Rein M G J, Endo, Akira, Flasche, Stefan, Davies, Nicholas G, Diamond, Charlie, van Zandvoort, Kevin, Funk, Sebastian, Auzenbergs, Megan, Rees, Eleanor M, Tully, Damien C, Emery, Jon C, Quilty, Billy J, Abbott, Sam, Villabona-Arenas, Ch Julian, Hué, Stéphane, Hellewell, Joel, Gimma, Amy, Jarvis, Christopher I, Clark, Andrew, Jit, Mark, Warren-Gash, Charlotte, Guthrie, Bruce, Wang, Harry H X, Mercer, Stewart W, Sanderson, Colin, McKee, Martin, Troeger, Christopher, Ong, Kanyin L, Checchi, Francesco, Perel, Pablo, Joseph, Sarah, Gibbs, Hamish P, Banerjee, Amitava, and Eggo, Rosalind M

Published
2020
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18. Effects of non-pharmaceutical interventions on COVID-19 cases, deaths, and demand for hospital services in the UK: a modelling study

Author

Jombart, Thibaut, O'Reilly, Kathleen, Endo, Akira, Hellewell, Joel, Nightingale, Emily S, Quilty, Billy J, Jarvis, Christopher I, Russell, Timothy W, Klepac, Petra, Bosse, Nikos I, Funk, Sebastian, Abbott, Sam, Medley, Graham F, Gibbs, Hamish, Pearson, Carl A B, Flasche, Stefan, Jit, Mark, Clifford, Samuel, Prem, Kiesha, Diamond, Charlie, Emery, Jon, Deol, Arminder K, Procter, Simon R, van Zandvoort, Kevin, Sun, Yueqian Fiona, Munday, James D, Rosello, Alicia, Auzenbergs, Megan, Knight, Gwen, Houben, Rein M G J, Liu, Yang, Davies, Nicholas G, Kucharski, Adam J, Eggo, Rosalind M, Gimma, Amy, and Edmunds, W John

Published
2020
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22. Recent Travel and Tuberculosis in Migrants: Data From a Low-Incidence Country.

Author

Schwalb, Alvaro, Kayumba, Kumvana, Houben, Rein M G J, and Bothamley, Graham H

Subjects
TUBERCULOSIS diagnosis, TUBERCULOSIS epidemiology, NATIONAL health services, HEALTH services accessibility, AUDITING, RESEARCH funding, NOMADS, TRAVEL, TRAVEL hygiene, DESCRIPTIVE statistics, CLINICAL pathology, MEDICAL screening, COMPARATIVE studies, EARLY diagnosis, DATA analysis software, CONFIDENCE intervals, DISEASE incidence, TIME, TUBERCULOSIS, DISEASE progression, SYMPTOMS
Abstract

Tuberculosis (TB) incidence rates among migrants are higher than those in low-incidence countries. We evaluated smear-positive, pulmonary TB notifications of foreign-born individuals, comparing time since arrival and time since last return travel to the country of origin. TB incidence suggests a time course consistent with recent infection during travel. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Treatment for radiographically active, sputum culture-negative pulmonary tuberculosis: A systematic review and meta-analysis

Author

Gray, Adam Thorburn, primary, Macpherson, Liana, additional, Carlin, Ffion, additional, Sossen, Bianca, additional, Richards, Alexandra S., additional, Kik, Sandra V., additional, Houben, Rein M. G. J., additional, MacPherson, Peter, additional, Quartagno, Matteo, additional, Rogozińska, Ewelina, additional, and Esmail, Hanif, additional

Published
2023
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27. Improving the quality of the Global Burden of Disease tuberculosis estimates from the Institute for Health Metrics and Evaluation

Author

Dodd, Peter J, primary, McQuaid, Christopher Finn, additional, Rao, Prasada, additional, Abubakar, Ibrahim, additional, Arinaminpathy, Nimalan, additional, Carnegie, Anna, additional, Cobelens, Frank, additional, Dowdy, David, additional, Fiekert, Kathy, additional, Grant, Alison D, additional, Wu, Jing, additional, Nfii, Faith Nekabari, additional, Shaikh, Nabila, additional, Houben, Rein M G J, additional, and White, Richard G, additional

Published
2023
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28. Social determinants of the changing tuberculosis prevalence in Viá»t Nam: Analysis of population-level cross-sectional studies

Author

Foster, Nicola, Nguyen, Hai V., Nguyen, Nhung V., Nguyen, Hoa B., Tiemersma, Edine W., Cobelens, Frank G. J., Quaife, Matthew, and Houben, Rein M. G. J.

Subjects
Prevalence studies (Epidemiology), Tuberculosis -- Statistics -- Social aspects -- Demographic aspects, Economic growth -- Evaluation -- Health aspects, Poor -- Health aspects -- Statistics, Biological sciences
Abstract

Background An ecological relationship between economic development and reduction in tuberculosis prevalence has been observed. Between 2007 and 2017, Viá»t Nam experienced rapid economic development with equitable distribution of resources and a 37% reduction in tuberculosis prevalence. Analysing consecutive prevalence surveys, we examined how the reduction in tuberculosis (and subclinical tuberculosis) prevalence was concentrated between socioeconomic groups. Methods and findings We combined data from 2 nationally representative Viá»t Nam tuberculosis prevalence surveys with provincial-level measures of poverty. Data from 94,156 (2007) and 61,763 (2017) individuals were included. Of people with microbiologically confirmed tuberculosis, 21.6% (47/218) in 2007 and 29.0% (36/124) in 2017 had subclinical disease. We constructed an asset index using principal component analysis of consumption data. An illness concentration index was estimated to measure socioeconomic position inequality in tuberculosis prevalence. The illness concentration index changed from -0.10 (95% CI -0.08, -0.16; p = 0.003) in 2007 to 0.07 (95% CI 0.06, 0.18; p = 0.158) in 2017, indicating that tuberculosis was concentrated among the poorest households in 2007, with a shift towards more equal distribution between rich and poor households in 2017. This finding was similar for subclinical tuberculosis. We fitted multilevel models to investigate relationships between change in tuberculosis prevalence, individual risks, household socioeconomic position, and neighbourhood poverty. Controlling for provincial poverty level reduced the difference in prevalence, suggesting that changes in neighbourhood poverty contribute to the explanation of change in tuberculosis prevalence. A limitation of our study is that while tuberculosis prevalence surveys are valuable for understanding socioeconomic differences in tuberculosis prevalence in countries, given that tuberculosis is a relatively rare disease in the population studied, there is limited power to explore socioeconomic drivers. However, combining repeated cross-sectional surveys with provincial deprivation estimates during a period of remarkable economic growth provides valuable insights into the dynamics of the relationship between tuberculosis and economic development in Viá»t Nam. Conclusions We found that with equitable economic growth and a reduction in tuberculosis burden, tuberculosis became less concentrated among the poor in Viá»t Nam., Author(s): Nicola Foster 1,2,*, Hai V. Nguyen 3,4,5, Nhung V. Nguyen 3, Hoa B. Nguyen 3, Edine W. Tiemersma 6, Frank G. J. Cobelens 4,5, Matthew Quaife 1,2, Rein M. [...]

Published
2022
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30. The molecular epidemiology of tuberculosis and the impact of HIV infection and antiretroviral therapy

Author

Houben, Rein Maria and Glynn, J. R.

Subjects
616.99
Abstract

This thesis investigates the epidemiology of tuberculosis (TB) disease in populations. It applies molecular epidemiological methods to elucidate the relative effects of HIV on TB disease following recent first infection, reactivation and recent reinfection with Mycobacterium tuberculosis (Mtb). Finally it aims to explore the impact of Antiretroviral Therapy (ART) on the incidence of TB in a population in rural Sub Saharan Africa. The data in chapters 2 and 3 is taken from a systematic literature review I performed of population based studies that reported TB molecular epidemiological data. In the subsequent chapters I analyse existing and newly collected data from the Karonga Prevention Study, set in Northern Malawi, to address the research questions. The results strongly suggest that HIV-infection increases an individual's risk of TB disease due to recent Mtb (re)infection more than through reactivation in populations with generalised HIV epidemics. The last chapter suggests that patients on ART experience a high risk of TB compared to HIV positive/ART naive patients, especially in the first months after initiating ART. Also, it appears that after the introduction of ART in 2005 TB incidence in Karonga District plateaued after declining in the previous 10 years. These findings strongly suggest that TB programmes in areas with generalised HIV epidemics should focus more of their efforts on reducing Mtb transmission. Improved collaboration between TB and ART programmes may help to reduce TB rates in the highly vulnerable ART receiving population and subsequently in the general population.

Published
2010
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35. Impact of Reversion of Mycobacterium tuberculosis Immunoreactivity Tests on the Estimated Annual Risk of Tuberculosis Infection.

Author

Schwalb, Alvaro, Emery, Jon C, Dale, Katie D, Horton, Katherine C, Ugarte-Gil, César A, and Houben, Rein M G J

Subjects
TUBERCULOSIS epidemiology, TUBERCULOSIS risk factors, INTERFERON gamma release tests, RISK assessment, SURVEYS, MYCOBACTERIUM tuberculosis, TUBERCULIN test, INFECTIOUS disease transmission, DISEASE prevalence, RESEARCH funding, CHILDREN
Abstract

A key metric in tuberculosis epidemiology is the annual risk of infection (ARI), which is usually derived from tuberculin skin test (TST) and interferon-γ release assay (IGRA) prevalence surveys carried out in children. Derivation of the ARI assumes that immunoreactivity is persistent over time; however, reversion of immunoreactivity has long been documented. We used a deterministic, compartmental model of Mycobacterium tuberculosis (Mtb) infection to explore the impact of reversion on ARI estimation using age-specific reversion probabilities for the TST and IGRA. Using empirical data on TST reversion (22.2%/year for persons aged ≤19 years), the true ARI was 2–5 times higher than that estimated from immunoreactivity studies in children aged 8–12 years. Applying empirical reversion probabilities for the IGRA (9.9%/year for youths aged 12–18 years) showed a 1.5- to 2-fold underestimation. ARIs are increasingly underestimated in older populations, due to the cumulative impact of reversion on population reactivity over time. Declines in annual risk did not largely affect the results. Ignoring reversion leads to a stark underestimation of the true ARI in populations and our interpretation of Mtb transmission intensity. In future surveys, researchers should adjust for the reversion probability and its cumulative effect with increasing age to obtain a more accurate reflection of the burden and dynamics of Mtb infection. [ABSTRACT FROM AUTHOR]

Published
2023
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39. The natural history of untreated pulmonary tuberculosis in adults: a systematic review and meta-analysis

Author

Sossen, Bianca, primary, Richards, Alexandra S, additional, Heinsohn, Torben, additional, Frascella, Beatrice, additional, Balzarini, Federica, additional, Oradini-Alacreu, Aurea, additional, Odone, Anna, additional, Rogozinska, Ewelina, additional, Häcker, Brit, additional, Cobelens, Frank, additional, Kranzer, Katharina, additional, Houben, Rein M G J, additional, and Esmail, Hanif, additional

Published
2023
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40. Cost-effectiveness and resource implications of aggressive action on tuberculosis in China, India, and South Africa: a combined analysis of nine models

Author

Menzies, Nicolas A, Gomez, Gabriela B, Bozzani, Fiammetta, Chatterjee, Susmita, Foster, Nicola, Baena, Ines Garcia, Laurence, Yoko V, Qiang, Sun, Siroka, Andrew, Sweeney, Sedona, Verguet, Stéphane, Arinaminpathy, Nimalan, Azman, Andrew S, Bendavid, Eran, Chang, Stewart T, Cohen, Ted, Denholm, Justin T, Dowdy, David W, Eckhoff, Philip A, Goldhaber-Fiebert, Jeremy D, Handel, Andreas, Huynh, Grace H, Lalli, Marek, Lin, Hsien-Ho, Mandal, Sandip, McBryde, Emma S, Pandey, Surabhi, Salomon, Joshua A, Suen, Sze-chuan, Sumner, Tom, Trauer, James M, Wagner, Bradley G, Whalen, Christopher C, Wu, Chieh-Yin, Boccia, Delia, Chadha, Vineet K, Charalambous, Salome, Chin, Daniel P, Churchyard, Gavin, Daniels, Colleen, Dewan, Puneet, Ditiu, Lucica, Eaton, Jeffrey W, Grant, Alison D, Hippner, Piotr, Hosseini, Mehran, Mametja, David, Pretorius, Carel, Pillay, Yogan, Rade, Kiran, Sahu, Suvanand, Wang, Lixia, Houben, Rein M G J, Kimerling, Michael E, White, Richard G, and Vassall, Anna

Published
2016
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41. Feasibility of achieving the 2025 WHO global tuberculosis targets in South Africa, China, and India: a combined analysis of 11 mathematical models

Author

Houben, Rein M G J, Menzies, Nicolas A, Sumner, Tom, Huynh, Grace H, Arinaminpathy, Nimalan, Goldhaber-Fiebert, Jeremy D, Lin, Hsien-Ho, Wu, Chieh-Yin, Mandal, Sandip, Pandey, Surabhi, Suen, Sze-chuan, Bendavid, Eran, Azman, Andrew S, Dowdy, David W, Bacaër, Nicolas, Rhines, Allison S, Feldman, Marcus W, Handel, Andreas, Whalen, Christopher C, Chang, Stewart T, Wagner, Bradley G, Eckhoff, Philip A, Trauer, James M, Denholm, Justin T, McBryde, Emma S, Cohen, Ted, Salomon, Joshua A, Pretorius, Carel, Lalli, Marek, Eaton, Jeffrey W, Boccia, Delia, Hosseini, Mehran, Gomez, Gabriela B, Sahu, Suvanand, Daniels, Colleen, Ditiu, Lucica, Chin, Daniel P, Wang, Lixia, Chadha, Vineet K, Rade, Kiran, Dewan, Puneet, Hippner, Piotr, Charalambous, Salome, Grant, Alison D, Churchyard, Gavin, Pillay, Yogan, Mametja, L David, Kimerling, Michael E, Vassall, Anna, and White, Richard G

Published
2016
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43. Evaluating the equity impact and cost-effectiveness of digital adherence technologies with differentiated care to support tuberculosis treatment adherence in Ethiopia: protocol and analysis plan for the health economics component of a cluster randomised trial

Author

Foster, Nicola, primary, Tadesse, Amare W, additional, McQuaid, Christopher Finn, additional, Gosce, Lara, additional, Abdurhman, Tofik, additional, Assefa, Demelash, additional, Bedru, Ahmed, additional, Houben, Rein MGJ, additional, Kalmthout, Kristian van, additional, Letta, Taye, additional, Mohammed, Zemedu, additional, Rest, Job van, additional, Umeta, Demekech G, additional, Weldemichael, Gedion T, additional, Yazew, Hiwot, additional, Jerene, Degu, additional, Quaife, Matthew, additional, and Fielding, Katherine L, additional

Published
2023
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44. Global Burden of Disease Due to Rifampicin-Resistant Tuberculosis in 2020: A Mathematical Modelling Analysis

Author

Menzies, Nicolas, primary, Allwood, Brian W., additional, Dean, Anna, additional, Dodd, Peter J., additional, Houben, Rein MGJ, additional, James, Lyndon, additional, Knight, Gwenan, additional, Meghji, Jamilah, additional, Nguyen, Linh, additional, Rachow, Andrea, additional, Schumacher, Samuel, additional, Mirzayev, Fuad, additional, and Cohen, Ted, additional

Published
2023
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47. Coverage and effectiveness of conditional cash transfer for people with drug resistant tuberculosis in Zimbabwe: A mixed methods study

Author

Timire, Collins, primary, Sandy, Charles, additional, Ferrand, Rashida A., additional, Mubau, Regina, additional, Shiri, Peter, additional, Mbiriyawanda, Obert, additional, Mbiba, Fredrick, additional, Houben, Rein M. G. J., additional, Pedrazzoli, Debora, additional, Bond, Virginia, additional, Foster, Nicola, additional, and Kranzer, Katharina, additional

Published
2022
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49. Recurrence due to Relapse or Reinfection With Mycobacterium tuberculosis: A Whole-Genome Sequencing Approach in a Large, Population-Based Cohort With a High HIV Infection Prevalence and Active Follow-up

Author

Guerra-Assunção, José Afonso, Houben, Rein M. G. J., Crampin, Amelia C., Mzembe, Themba, Mallard, Kim, Coll, Francesc, Khan, Palwasha, Banda, Louis, Chiwaya, Arthur, Pereira, Rui P. A., McNerney, Ruth, Harris, David, Parkhill, Julian, Clark, Taane G., and Glynn, Judith R.

Published
2015

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