The third day of the 51st Union World Conference on Lung Health saw a focus on TB prevention most often in relation to the global efforts against the COVID-19 pandemic. With sessions featuring the challenge of delivering prevention therapy to high risk groups, and research into the crossover of diagnostic testing and monitoring for COVID-19 with HIV and TB. Late-breaking science on the evolving response to COVID-19 was also explored, including the development of diagnostic tests, mortality rates for people living with TB and the impact on essential services.
Read more about these highlights below.
TB preventive therapy: we need to do better
This session looked at some of the challenges facing policy makers and service providers in delivering preventive therapy to high risk groups. Researchers reported encouraging progress in people with living with HIV in South Africa (OA-15-594-22) and Uganda (OA-15-595-22) and also noted some advances with young children in the DRC (OA-15-596-22).
Special Session: COVID-19: different strokes
While SARS-CoV2 has spread across the world, countries’ responses have varied around the globe. This session focused on the different approaches and the impact of these strategies on country statistics and experiences. The discussion covered the reasons for different strategies (including lessons learned from other epidemics), the pros and cons of these approaches and the possible translational lessons for tackling other epidemics.
Leveraging a multiplex platform for TB, HIV and coronavirus for diagnostic testing and clinical monitoring: country experiences
One of the outcomes of the COVID-19 pandemic has been the crossover of diagnostic testing and monitoring for other infectious diseases like HIV and TB. Researchers reported the dual use of GeneXpert machines for SARS-CoV-2 diagnosis in Nigeria, Rwanda and Indonesia.
The Union late-breaker session on COVID-19
The science around SARS-CoV-2, the coronavirus that causes COVID-19, continues to evolve. This key session heard findings from researchers around the development of diagnostic tests, mortality rates for people living with TB and the impact on essential services:
Comparative evaluation of the clinical accuracy of SARS-CoV-2 serological rapid diagnostic tests and manual ELISAs
The clinical accuracy of 25 commercially available SARS-CoV-2 antibody tests in five countries – Brazil, Italy, Spain, Switzerland and the USA – was determined. The study results suggest that the majority of antibody rapid diagnostic tests (RDTs) have insufficient sensitivity and specificity, but there are several high performing lab-based enzyme-linked immunosorbent assay (ELISAs) that meet World Health Organization target product profile targets.
LB-2090-22-High mortality among persons with comorbid rifampicin-resistant TB and COVID-19 in Khayelitsha, South Africa
This study looked at high mortality in people with rifampicin-resistant tuberculosis during April 2020, in Khayelitsha, South Africa. It included 181 active RR-TB patients; a quarter were tested for COVID-19 and just over a third (37%) tested COVID-19 positive. Among those co-infected, eight (47%) died. Few newly diagnosed RR-TB patients were investigated for COVID-19 suggesting missed opportunities to detect COVID-19.
LB-2122-22-TB and COVID-19 co-infection among people with cough screened during active case finding of COVID-19 in the community with a high prevalence of TB
This study shows the experience of screening for both tuberculosis and COVID-19 at the same time, using Xpert MTB/Rif and SARV-CoV-2 PCR tests, in the north of Lima during the programmatic activities on COVID-19 response in Peru.
LB-2051-22-Potential impact of the COVID-19 pandemic on essential TB services in Sri Lanka
Common respiratory origin and interference with host immunity results in many clinical similarities between tuberculosis (TB) and COVID-19. Due to COVID-19, the Sri Lankan healthcare system is stretched beyond capacity. The catastrophic effect of COVID-19 on normality of the population and healthcare services has a negative impact on TB case detection.
Researchers sharing with communities: TBTC study
A phase 3 trial examining the possibility of shortening the duration and reducing the pill burden of therapy for drug-sensitive pulmonary TB has recently come to an end. The study tested the efficacy and safety of two four-month alternatives to the current six-month treatment. In both experimental regimens, rifampicin was replaced by high dose rifapentine, and in one of the regimens, moxifloxacin replaced ethambutol.
The research team presented their findings to conference delegates yesterday, and today the study’s principal investigators, CRAG members, and a study team community representative presented the same the same findings in this Community Connect session, in order to be fully transparent and accountable with community members and civil society.