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Matthew Saunders

@mjsaunder.bsky.social
45 followers 58 following 21 posts

Public health physician and social epidemiologist passionate about addressing inequities in health and wellbeing through practice, research, and advocacy www.researchgate.net/profile/Matthe…

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Matthew Saunders @mjsaunder.bsky.social · 21/07/2026
Take home message: People with bedaquiline-resistant TB experience disproportionate morbidity and mortality yet have the fewest treatment options available to them.
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Matthew Saunders @mjsaunder.bsky.social · 21/07/2026
Median 5 drugs a day for ~18 months with high rates of injectable use; median ~6 months to culture conversion indicating persistence infectiousness; and less than two thirds (~60%) were alive and free of TB after 18 months.
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Matthew Saunders @mjsaunder.bsky.social · 21/07/2026
Bedaquiline resistance is increasing globally and threatens to undermine efforts to end TB. In this cohort study from Uzbekistan, we describe the characteristics, treatment strategies, and long-term health outcomes of people with bedaquiline-resistant TB academic.oup.com/ofid/advance...
academic.oup.com
Characteristics, treatment strategies, and long-term health outcomes of people with bedaquiline-resistant tuberculosis in Karakalpakstan, Uzbekistan – a retrospective cohort study
AbstractBackground. Bedaquiline resistance is increasing globally, threatening effectiveness of short regimens for rifampicin/multi-drug resistant (RR/MDR)
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Reposted by Matthew Saunders
Tom Wingfield @tomwingfield.bsky.social · 23/06/2026
📢 Our new Thorax @bmj.com study. In England, 574 people with TB were diagnosed only after death, 2010–2022: ~𝗼𝗻𝗲 𝗽𝗲𝗿𝘀𝗼𝗻 𝗲𝘃𝗲𝗿𝘆 𝘄𝗲𝗲𝗸. Postmortem TB diagnosis is the ultimate diagnostic delay & should be a “never event”. 🔗 doi.org/10.1136/thor... @lstmnews.bsky.social Thanks @ukhsa.bsky.social
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Reposted by Matthew Saunders
Lara Goscé @laragosce.bsky.social · 13/06/2026
Poverty is a major driver of TB.Conditional cash transfers combined with counselling improve pre-treatment loss to follow-up.In this economic analysis our modelling projections show that this intervention is cost-effective and can reduce incidence and mortality. www.sciencedirect.com/science/arti...
sciencedirect.com
Cost-effectiveness of conditional cash transfers with pre- and post-test tuberculosis counselling in South Africa: a modelling analysis
Tuberculosis (TB) disproportionately affects low-income populations due to socioeconomic barriers. Conditional cash transfers (CCTs) are promising str…
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Matthew Saunders @mjsaunder.bsky.social · 02/06/2026
So...what would happen to the global TB epidemic if we "eliminated" undernutrition? Our paper out now @lancetgh.bsky.social, where we combined estimates from our review (academic.oup.com/ije/article/...) with population-specific BMI distributions to find out...(www.thelancet.com/journals/lan...
thelancet.com
Global, regional, and national estimates of tuberculosis incidence averted by eliminating undernutrition in adults: a modelling study
Almost a quarter of global tuberculosis incidence in adults could be averted by eliminating undernutrition, approximately two-and-a-half times higher than current estimates. These findings highlight t...
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Reposted by Matthew Saunders
Tom Wingfield @tomwingfield.bsky.social · 19/05/2026
🧵 Our new @thelancet.com Regional Health Africa study from #SierraLeone: MORE THAN ONE IN FOUR PEOPLE WITH MDR/RR-TB DIED (𝟮𝟲%, 191/739) before treatment, during treatment, and to 12 months after "treatment success" (key figs 👇) TB care must extend beyond TB “cure”. 🔗 tinyurl.com/2p9zabwz #MDR-TB
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Finn McQuaid @cfmcquaid.bsky.social · 12/05/2026
So...what would happen to the global TB epidemic if we "eliminated" undernutrition? Our paper out now @lancetgh.bsky.social, where we combined estimates from our review (doi.org/10.1093/ije/...) with population-specific BMI distributions to find out...(www.sciencedirect.com/science/arti...)
sciencedirect.com
Global, regional, and national estimates of tuberculosis incidence averted by eliminating undernutrition in adults: a modelling study
Current efforts to reduce global tuberculosis incidence have proved insufficient, highlighting that urgent action is needed to address underlying modi…
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Matthew Saunders @mjsaunder.bsky.social · 07/11/2025
Climate change and tuberculosis: www.thelancet.com/journals/lan.... Podcast with @cfmcquaid.bsky.social here: open.spotify.com/episode/28jr...
thelancet.com
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...
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Finn McQuaid @cfmcquaid.bsky.social · 31/10/2025
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...
thelancet.com
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...
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The Lancet Infectious Diseases @thelancetinfdis.bsky.social · 28/10/2025
New comment: Tuberculosis and undernutrition: improving estimates to reinforce the policy imperative www.thelancet.com/journals/lan...
thelancet.com
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...
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Matthew Saunders @mjsaunder.bsky.social · 28/10/2025
with @cfmcquaid.bsky.social @tbtakenseriously.bsky.social Peter Cegielski @raclark18.bsky.social @jaseddon.bsky.social Leo Martinez Madhavi & Anurag Bhargava @richardwhite321.bsky.social @reinhouben.bsky.social @tb-lshtm.bsky.social @cmmid-lshtm.bsky.social @lshtm-tbmod.bsky.social
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Matthew Saunders @mjsaunder.bsky.social · 28/10/2025
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/...
academic.oup.com
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
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Matthew Saunders @mjsaunder.bsky.social · 28/10/2025
Estimating the PAF for a continuous measure is conceptually tricky, but 2024 estimates from WHO use a risk ratio which excludes several large studies, pools together different populations, and uses different comparators.
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Matthew Saunders @mjsaunder.bsky.social · 28/10/2025
“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...
thelancet.com
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...
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Matthew Saunders @mjsaunder.bsky.social · 10/09/2025
@cfmcquaid.bsky.social @tbtakenseriously.bsky.social @jaseddon.bsky.social @petedodd24.bsky.social @tb-lshtm.bsky.social #endtb
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Matthew Saunders @mjsaunder.bsky.social · 10/09/2025
Key message: Eliminating undernutrition could prevent millions of people from developing TB. Scaling up nutritional interventions (which are likely to have myriad social and health benefits), particularly for populations in greatest need, should be an integral part of the global TB response.
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Matthew Saunders @mjsaunder.bsky.social · 10/09/2025
We estimated that eliminating moderate/severe undernutrition (BMI<17) would avert ~17% of global adult incidence, while eliminating all undernutrition (BMI<18.5) would avert ~27%, three times higher than current estimates.
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Matthew Saunders @mjsaunder.bsky.social · 10/09/2025
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...)
doi.org
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...
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Matthew Saunders @mjsaunder.bsky.social · 10/09/2025
We estimated that eliminating moderate/severe undernutrition (BMI<17) would avert ~17% of global adult incidence, while eliminating all undernutrition (BMI<18.5) would avert ~27%, three times higher than current estimates.
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Matthew Saunders @mjsaunder.bsky.social · 09/09/2025
Key message: Addressing undernutrition must be central to the global TB response. #EndTB @cfmcquaid.bsky.social @reinhouben.bsky.social @raclark18.bsky.social @tb-lshtm.bsky.social
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Matthew Saunders @mjsaunder.bsky.social · 09/09/2025
Based on these results and the global BMI distribution, we estimated a relative risk of tuberculosis associated with undernutrition of 5.0 (95% CI: 4.2–5.9), substantially higher than previous estimates.
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Matthew Saunders @mjsaunder.bsky.social · 09/09/2025
Our results show how TB risk is highest at the lowest BMI values and decreases nonlinearly as BMI increases, with the steepest reduction in risk occurring when moving through underweight and normal weight ranges, and more modest reductions continuing through overweight and obese ranges.
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Matthew Saunders @mjsaunder.bsky.social · 09/09/2025
We found an inverse, dose-response, nonlinear relationship between BMI and TB risk in the full underweight to obese range, consistent across populations and countries with a high versus lower TB burden.
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Matthew Saunders @mjsaunder.bsky.social · 09/09/2025
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/...
doi.org
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
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Matthew Saunders @mjsaunder.bsky.social · 12/08/2025
Key message: Interventions to address household poverty and interrelated personal risk factors could substantially reduce TB burden in Peru. Our results inform intervention design; and support more effective implementation of poverty reduction/social protection within the global TB response.
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Matthew Saunders @mjsaunder.bsky.social · 12/08/2025
The global TB epidemic is driven by social determinants. In this case-control study in Peru, we characterised the associations between multidimensional household poverty, personal risk factors, and TB. @tb-lshtm.bsky.social idpjournal.biomedcentral.com/articles/10....
idpjournal.biomedcentral.com
The social determinants of tuberculosis: a case-control study characterising pathways to equitable intervention in Peru - Infectious Diseases of Poverty
Background Despite being key components of global tuberculosis policy, poverty reduction and social protection interventions have been inconsistently implemented. We aimed to characterise how poverty ...
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Reposted by Matthew Saunders
The Union @theunion.org · 07/08/2025
The Union's TB Undernutrition working group is hosting a webinar with Dr Matthew Saunders. 📅 21 August at 2pm CET Dr Saunders (@lshtm.bsky.social‬) will share findings from a new analysis that redefines the relationship between BMI and TB incidence. 📧 To join email membership@theunion.org.
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