TBnet webinar today - November 24, 16:00 CET - will focus on modelling and subclinical TB – an asymptomatic but infectious condition. Can we predict how many people with subclinical TB can progress, regress or even persist in a chronic disease state?
Chair - Berit Lange, Speaker - Alex Richards, expert panel - Torben Heinsohn & Wolfgang Bock
A new multicentre study by PTBNET
The study is published in Thorax last month. It is called: Performance of QuantiFERON-TB Gold Plus assey in paediatric tuberculosis.
“The results indicate that the latest generation IGRA assay, QFT-Plus, does not perform better than previous generation IGRAs or the TST in children with TB disease. Overall, tests performed worse in CNS and miliary TB, and in immunocompromised children. None of the tests evaluated had sufficiently high sensitivity to be used as a rule-out test in children with suspected TB."
Read it here: https://pubmed.ncbi.nlm.nih.gov/36283826/
The Deadly Divide 2
TBnet members are invited to participate in the Deadly Divide 2, a survey for the Community Accountability Report on the global response to END TB.
The report will be presented at the 2023 UN High Level Meeting on TB. The link is provided by Timur Abdullaev, TB Advocate and the Stop TB Partnership Community Delegation. It is a good chance to convey your opinion as for the access to TB drugs in Europe and other issues you meet in your clinical practice regarding TB.
Note, if the link does not open use the password: “English”
The Union conference 2022, how was it and what have we learned?
reflections of the participants
Dr Jessica Potter, MBBCh PhD
Honorary Clinical Lecturer, Queen Mary University of London
“And just like that, the Union Conference is over for another year. Despite the benefits of being able to catch up on missed sessions, hop from talk to talk with just the click of a mouse, reduced environmental impact and of course avoiding the international visa obstacle course - certainly missed seeing everyone in person. It was great to see so many TBnet members presenting their research from sessions across the conference. Morten Ruhwald, past mentor at TBnet academies and our very own Christoph Lange updated us on the progress of stool and other non-sputum based diagnostics for TB. Maia Kipiani from the National TB Centre in Georgia joined the rest of the team from the second stage of the STEAM trial including the much anticipated all oral 9-month regimen for MDR-TB. There were hugely informative sessions on diagnostics in TB infection and, as a clinician, I was particularly interested in the session looking at where the treatment line starts and stops on the spectrum between infection and disease, as well as the proliferating evidence-base for post TB lung disease.
While there is still work to be done, the Union conference continues to cultivate a space to ensure the voice of affected communities are heard and broader work on the job of ending TB can be discussed. Advocacy is central to success of TB elimination and has driven the research agenda forwards in many areas. Alongside the voices of people affected by TB, researchers and healthcare workers can contribute by using their political power to demand investment and policy change. Along with parliamentarians and colleagues from the network UK Academics and Professionals to end TB, I chaired a session exploring how we can organise and mobilise these groups alongside people affected by TB. I particularly recommend Yanika Hauser's talk on the 'how to' of this important work - her many years of experience in the field of TB advocacy condensed into a highly educational 6 minutes!”
Ilaria Motta, MD, DTM&H, PhD
TB-PRACTECAL trial, Medical Monitor&Clinical Advisor
Médecins Sans Frontières / Doctors Without Borders (MSF) UK
“TB-PRACTECAL, a multi-country, multi-site randomized controlled clinical trial, presented final evidence of bedaquiline- and pretomanid-based regimens to shorten efficaciously and safely treatment for rifampicin-/multidrug-resistant TB to just six-months. 552 patients were randomized, unfavourable outcomes in mITT population were 11.7%, 23.5% and 13.5% in BPaLM, BPaLC and BPaL, respectively, compared to 40.9% in control arm. All three investigational arms showed non-inferiority compared to control arm, and BPaLM/BPaL showed additionaly superiority.
Safety in all three investigational arms (BPaLM, BPaLC and BPaL) was better than standard of care, with less number of adverse effects grade 3 and above and/or serious adverse events. Cost -effectiveness of shortened regimens strengthen the case for programmatic roll out for BPaLM/BPaL regimens.
TBnet is not part of this work, however, the trial is a great progress for the whole clinical research community and great news for the patients.”
The UNITE4TB Community Advisory Group message via Irina Kontsevaya,
PhD, Division of Clinical Infectious Diseases
Research Center Borstel
“During this year’s Union World Conference on Lung Health, the UNITE4TB Community Advisory Group (CAG) took part in the Community Connect session, held virtually on Wednesday 9 November. The Group explained how to engage the community in tuberculosis (TB) research and shared what they have achieved so far in UNITE4TB.
The importance of community engagement
Engaged and educated communities are an asset to projects that involve clinical trials, like UNITE4TB. Clinical trial sites that are paired with well-established and supported community engagement (CE) programs are often better positioned to conduct smoothly run trials with good levels of recruitment and improved retention of trial participants.
Strong relationships with community stakeholders and groups of advisors, such as UNITE4TB’s CAG, are critical for managing many trial-related issues. CE programs can also activate local stakeholders as advocates for increased investment in Research & Development (R&D) for new tools, faster approval, and access to healthcare and educational resources.
The role of the CAG within UNITE4TB
The UNITE4TB CAG has been developed with representation from all regions involved in the project. Led by Consortium partner the European Lung Foundation (ELF), the CAG members bring years of CE experience, providing feedback and suggestions during all aspects of the project through a collaborative and participatory approach.
Right from the start of UNITE4TB, the CAG has provided advice and expertise to the consortium on all activities that involve communities and TB survivors. During the course of the project, the CAG will help to produce educational materials aimed at communities affected by TB and will advise on the implementation of CE at trial sites.
One of the first activities the CAG has undertaken is to emphasize the importance of the language used within the project. They have stressed the need to engage with communities in terms they understand, and how to communicate with trial participants regarding adherence.
During the Community Connect session at this year’s Union Conference, participants heard from several members of the UNITE4TB CAG who talked about how to involve the community, how to build a structure and communication, and what language to use.
The key take-home message from the session: Meaningful engagement is a win-win for all! Communities are not passive recipients; they have great expertise to bring to the table in R&D projects and need to be meaningfully engaged.
Wrapping up the session, Blessina Kumar, UNITE4TB Community Advisory Group member and CEO of The Global Coalition of TB Advocates said: "We're very excited that within UNITE4TB we have been engaged right from the start. We have been given the space to view our thoughts. This is very exciting and very welcome.""