Tweetable abstract This study provides an update on the implementation of lateral flow LAM testing in national guidelines and identifies the major barriers that may be preventing widespread use of the testhttps://bit.ly/44NfxZ3

Networks are critical for leadership development, but not all networks and networking activities are created equally. Women and people of color face unique challenges accessing networks, many of which were exacerbated during the COVID-19 pandemic. Virtual platforms offer opportunities for global professionals to connect and can be better tailored to meet the needs of different groups. As part of the Consortium of Universities for Global Health annual meeting in 2021, we organized a networking session to provide a networking space for emerging women leaders in global health (i.e. trainees, early career professionals, and/or those transitioning to the field). We evaluated the virtual networking session to better understand participants’ perception of the event and its utility for professional growth and development. We distributed online surveys to participants immediately after the event and conducted a 3-month follow-up. Out of 225 participant, 24 responded to both surveys and their data was included in the analysis. We conducted descriptive quantitative analysis for multiple choice and Likert scale items; qualitative data was analyzed for themes. Participants represented 8 countries and a range of organizations. Participants appreciated the structure of the networking session; all participants agreed that they met someone from a different country and most indicated they had plans to collaborate with a new connection. When asked if the event strengthened their network and if they will keep in touch with new people, most participants strongly agreed or agreed in both surveys. However, after the follow-up, participants noted challenges in sustaining connections including lack of follow-up and misaligned expectations of networks. The virtual networking event brought together women in global health from diverse backgrounds. This study found that while networking events can be impactful in enhancing professional networks, ensuring sustained connections remains a challenge. This study also suggests that measures to increase the depth and meaningfulness of these connections in a virtual setting and enabling post-event collaboration can help networks become more inclusive and sustainable.

In several low-income countries, the transport of sputa could take up to one week to reach the laboratories, resulting in increased contamination rates and a loss of growth. The aim of this study was to evaluate the effect of the OMNIgene-SPUTUM in preserving Mycobacterium tuberculosis on sputum samples simulating three hypothetical scenarios for conservation and/or decontamination: (1) sputum was mixed with OMN and conserved at room temperature for five days and then processed for culture (OMN); (2) sputum cultures followed the routine standing operating procedure at day 0 (STD); and (3) sputum samples were kept at room temperature for five days and mixed with the standard decontamination reagent (SDT5) and then processed for culture. The positivity rate based on smear microscopy was 36.4%, 29.1%, and 27.3% for STD, STD5, and OMN, respectively. The proportion of positive results by liquid culture (MGIT) was 39.1% (43/110) for STD, 26.4% (29/110) for STD5, and 20.0% for OMN (22/110). The overall concordance of liquid culture results was 51.8% (57/110): 37.3% (41/110) for negative results, 11.8% (13/110) for MTBC growth, and 2.7% (3/110) for contaminated results. The OMN arm showed better performance in solid culture than in liquid culture, with a notable reduction in contaminated results.

Although tuberculosis is a preventable and treatable disease, its management has been challenging for tuberculosis control and prevention programs in low- and middle- income countries such as Mozambique. We assessed the TB knowledge and healthcare-seeking behaviors among adults with HIV and caregivers of paediatric patients with symptoms of TB. The study was conducted between February and October 2023 at Manhiça District Hospital. A total of 60 interviews were conducted with people with HIV and caregivers of paediatric patients showing symptoms of TB. The interviews were transcribed, coded using an excel matrix, and analyzed using a content analysis approach. Half of the participants recognized airborne transmission through coughing as the main mode of TB transmission, while others were unsure or linked TB to sociocultural beliefs. Coughing was identified by most as the main symptom, with some also mentioning chest pain, bleeding, fatigue or weakness, weight loss, fever and night sweats. Many respondents believed that avoiding sharing utensils was the main way of preventing TB. Respecting the respondents’ reasons and time taken to seek health care, our findings revealed that most participants had experienced the persistent coughing for more than 3 weeks. Some sought medical care, but did not see any improvement, while others chose to wait for their next scheduled doctor visit, hoping to address their symptoms. Our results showed that delays in seeking care were common among participants with TB symptoms, reflecting limited awareness of the disease. Factors such as waiting for the next scheduled doctor’s visit, misinterpreting symptoms, and misconceptions about TB may have contributed to these delays. To address this, raising awareness about TB transmission, symptoms and prevention, dispelling myths through health education, and improving TB symptom follow-up through a coordinated approach across various patient entry points are essential.

Background: Tuberculosis treatment monitoring is hindered by the lack of a rapidly measured biomarker that accurately predicts clinically relevant outcomes. Symptom screening poorly correlates with bacillary burden. Although culture is a direct measure of viable bacillary burden, the long turnaround time makes it clinically irrelevant. Methods: The tuberculosis treatment monitoring potential of stool-based, quantitative PCR was prospectively assessed among 231 microbiologically confirmed tuberculosis participants of all ages from Eswatini, Tanzania, and Mozambique. Stool qPCR results were compared to sputum culture, persistent symptoms, drug resistance, and WHO tuberculosis outcomes. Results: Quantitative bacillary burden measured by stool qPCR strongly correlated with sputum culture at baseline (Spearman correlation rs = 0.79; p < 0.001). Stool was successfully collected at >90% of all timepoints, while sputum collection decreased to <50% at the end of therapy. Participants with isoniazid or rifampin resistance demonstrated decreased bacillary clearance by sputum culture and stool qPCR during the first two weeks of treatment. Participants who remained culture positive at 2 months had a slower decrease in bacillary burden measured by stool qPCR compared to those who were culture negative by 2 months. The odds of a participant being culture positive at two months was associated with i) a lower initial qPCR cycle threshold (Odds ratio (OR) = 0.792; p = 0.004), and ii) a smaller absolute difference between the qPCR cycle threshold measured at two weeks and baseline (OR = 0.72; p = 0.0006). Neither sputum culture, sputum Xpert Ultra, or stool qPCR were associated with resolution of symptoms or in-treatment death. Conclusions: Stool-based tuberculosis treatment monitoring correlates with sputum culture but provides results faster, leverages a more accessible specimen, and identifies patients with tuberculosis who are at risk for drug resistance and persistent 2-month culture positivity. None of the quantitative tests of bacillary burden singularly could predict symptom resolution or death.

New diagnostic tests and alternative samples to diagnose tuberculosis in children are needed to tackle the diagnostic gap of pediatric tuberculosis. The Determine TB LAM Ag test in urine demonstrated sensitivity of 15.9% and specificity of 90.6%. Collecting the urine in adhesive bag was an independent risk factor for positivity (odds ratio, 11.38; P < .01).