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Rein Houben

@reinhouben.bsky.social
1.1K followers 189 following 36 posts

Professor of Tuberculosis Epidemiology @LSHTM - TB nerd

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Rein Houben @reinhouben.bsky.social · 21/07/2026
Very exciting to see this out. Massive lift from team, highlighting how we need to dare to think big if we want to make a meaningful dent in the ongoing ongoing burden of TB. We will not get there by small steps. Instead should focus on how to make possible the apparently impossible.
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Katherine Horton @kchorton.bsky.social · 21/07/2026
Our new paper in @nathealth.nature.com shows that population-level #TB interventions are likely to have more meaningful impact on disease burden than interventions that only reach routinely diagnosed individuals or their households. www.nature.com/articles/s44... 1/7
nature.com
Global impact and cost-effectiveness of tuberculosis interventions - Nature Health
A modelling analysis at a global scale estimates that three interventions (vaccination, community-wide screening and prison screening programmes) could prevent more than 10% of tuberculosis cases betw...
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Alvaro Schwalb @aschwalbc.bsky.social · 13/02/2026
1/📢 In our new publication, we estimate that in 2022, 134 million people worldwide had a recent Mycobacterium tuberculosis (Mtb) infection and were at high risk of progressing to TB disease. Read the full paper in PLOS Medicine (tinyurl.com/mtbinfection). #TBSky
tinyurl.com
Estimating the global burden of viable Mycobacterium tuberculosis infection: A mathematical modelling study
Alvaro Schwalb and colleagues conducted a mathematical modelling study to estimate the global burden of viable Mycobacterium tuberculosis--that which can cause disease and be transmitted--to help guid...
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PLOS Medicine @plosmedicine.org · 24/02/2026
In this modeling study, Allison Portnoy and colleagues investigate the potential impact of reduced international donor funding on the household economic burden of tuberculosis in low- and middle-income countries 🧪 #MedSky #TB plos.io/4ryyBFX
plos.io
The potential impact of reduced international donor funding on the household economic burden of tuberculosis in low- and middle-income countries: A modeling study
In a modelling study, Allison Portnoy and colleagues investigate the potential impact of reduced international donor funding on the household economic burden of Tuberculosis in low- and middle-income ...
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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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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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Rein Houben @reinhouben.bsky.social · 28/10/2025
very nice two-punch set of papers led by @mjsaunder.bsky.social and @cfmcquaid.bsky.social. First fix the many issues with recent reviews of BMI and TB, and then follow it through on the consequences for the key PAF metrics. Undernutrition was, is and remains a key driver of global TB burden.
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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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chaelinkim.bsky.social @chaelinkim.bsky.social · 20/10/2025
When fluoroquinolone resistance status is unknown, empirical use of BPaLM (adding moxifloxacin to BPaL) is cost-effective as a replacement for BPaL even with high fluoroquinolone resistance levels! 🦠💊 doi.org/10.1371/jour...
doi.org
Impact of fluoroquinolone resistance on the cost-effectiveness of empiric treatment for multidrug- or rifampicin-resistant tuberculosis
The WHO recommends the bedaquiline, pretomanid, and linezolid (BPaL) regimen with the additional fluoroquinolone antibiotic moxifloxacin (BPaLM) for initial treatment of multidrug- or rifampicin-resis...
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Rein Houben @reinhouben.bsky.social · 16/10/2025
Very important and helpful study, getting after the gap left by CXR and symptom pre-screening in disease prevalence surveys. Congrats @tomscriba.bsky.social and team on getting this done and through the publishing process.
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Katherine Horton @kchorton.bsky.social · 12/10/2025
Understanding patterns of #TB exposure and transmission is needed for targeted prevention strategies. In our latest pre-print, @petedodd24.bsky.social and I estimated the proportion of TB exposure to and transmission from sex and age groups for 177 countries. bit.ly/4nbV492
medrxiv.org
A global analysis of patterns of tuberculosis exposure and transmission
Tuberculosis (TB) is a major public health concern and the leading infectious cause of mortality globally. The disease exhibits strong prevalence patterns by age and sex, but the implications of these...
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Rein Houben @reinhouben.bsky.social · 07/10/2025
In a new preprint (NOT PEER REVIEWED) we continue to explore the challenge of overtreatment in community screening. It seems the benefits of TB treatment far outweigh the harms, especially once we accept that sputum culture is not perfect. Important food for thought. www.medrxiv.org/content/10.1...
medrxiv.org
Do no harm - re-evaluating the risks of overtreatment in community-wide tuberculosis screening
Background Community-wide screening is a crucial strategy to end tuberculosis (TB), but a common concern is potential harm from overtreatment following false positive diagnoses. However, current refer...
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Rein Houben @reinhouben.bsky.social · 11/09/2025
Excellent work led by @aschwalbc.bsky.social, building on the trials by the ACT3 team @thuanhnguyen.bsky.social to show how investing in TB screening can save lives, and start to save money quickly. As TB continues to wreak havoc, we need to embrace bold solutions to make a real and lasting impact.
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TB Proof @tbproof.bsky.social · 10/09/2025
Finishing TB treatment isn’t the finish line. Our TB Champions are speaking out, showing why #PostTBCare needs urgent research. Their voices are the drivers of change. 💛 #EndTB #PostTB @posttbcare.bsky.social
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Rein Houben @reinhouben.bsky.social · 09/09/2025
Marvellous work led by @mjsaunder.bsky.social and @cfmcquaid.bsky.social to find more data and do better analyses to get to this crucial number. Now for WHO to update their PAF estimates, so we can follow up the measuring with better and properly prioritised managing.
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Katherine Horton @kchorton.bsky.social · 27/08/2025
Community screening for #tuberculosis could extend the reach of #TB services, but evidence on its effectiveness is limited. In our latest preprint, we examine the epidemiological impact of trade-offs in diagnostic algorithm, population coverage, and duration of screening. 1/n bit.ly/3UK7pFD
medrxiv.org
Exploring trade-offs in diagnostic algorithm, population coverage, and duration of community screening for tuberculosis
Background Current tuberculosis (TB) prevention and care strategies have failed to reduce disease burden at the pace required to meet global targets. Community screening may enable more rapid declines...
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Katherine Horton @kchorton.bsky.social · 14/07/2025
Our work estimating the potential impacts of reductions in international donor funding for #TB is now out in @lancetgh.bsky.social: bit.ly/3TDl28T @raclark18.bsky.social @cfmcquaid.bsky.social @alexandra-richards.bsky.social @top-j.bsky.social @reinhouben.bsky.social @richardwhite321.bsky.social
bit.ly
The potential impact of reductions in international donor funding on tuberculosis in low-income and middle-income countries: a modelling study
We estimate substantial potential impacts on tuberculosis morbidity and mortality due to reductions in international donor funding. Expanded support from domestic and international donors is essential...
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Katherine Horton @kchorton.bsky.social · 04/07/2025
In our latest personal view in @lancetrespirmed.bsky.social, we argue for the inclusion asymptomatic #tuberculosis in vaccine trial endpoints to potentially reduce the size, length, and cost of trials. doi.org/10.1016/S221... @lshtm-tbmod.bsky.social @tb-lshtm.bsky.social
Figure 1. Estimated number of trial endpoints in the control group of a prevention-of-disease vaccine trial in a high disease-burden setting showing number of endpoints on the y-axis and time in months on the x-axis. For bacteriologically confirmed symptomatic tuberculosis disease endpoints only, we estimate 69 endpoints, and for combined bacteriologically confirmed asymptomatic and symptomatic tuberculosis disease endpoints, we estimate 151 endpoints. Scenario assumes symptomatic disease incidence before trial screening of 300/100 000 per year and following 10 000 individuals over 3 years. Prevalent symptomatic and asymptomatic tuberculosis disease are screened out in month 0 and are not trial endpoints. Active screening occurs every 6 months for both scenarios and participants self-presenting with symptoms suggestive of tuberculosis disease would also be investigated.
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James Seddon @jaseddon.bsky.social · 03/06/2025
TB seems to comprehensively disrupt the normal physiological progression of puberty. academic.oup.com/jid/advance-...
academic.oup.com
Impact of puberty on immune responses to Mycobacterium tuberculosis in South African adolescents
AbstractBackground. As individuals progress through adolescence, their risk of tuberculosis (TB) increases and the type of disease that develops changes, w
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Finn McQuaid @cfmcquaid.bsky.social · 30/05/2025
TB & climate change: @who.int report out now, building on an analytical framework we developed to explore the intersections and implications for the TB epidemic. Key message? TB should be considered a climate-sensitive disease www.who.int/publications...
who.int
Tuberculosis and climate change: analytical framework and knowledge gaps
This report explores the intersection of tuberculosis (TB) and climate change, highlighting how climate-related challenges such as food and water insecurity, displacement, and disrupted healthcare acc...
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Rein Houben @reinhouben.bsky.social · 27/05/2025
Amid all the bad news in Global Health, perhaps some good news? A first analysis on the risk of false positive diagnoses in community-screening for tuberculosis using Xpert shows our clinic-based data is likely (very) wrong and overestimates false positives by >80%: tinyurl.com/yfecute9.
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LSHTM TB Modelling Group @lshtm-tbmod.bsky.social · 16/05/2025
Are you interested in #TB and have experience in #modelling infectious diseases? Come join us in the TB Modelling Group at #LSHTM! We're advertising for a 1 year Research Fellow position, with a closing date of 30 May 2025 👉 jobs.lshtm.ac.uk/vacancy.aspx...
jobs.lshtm.ac.uk
Job Opportunity at LSHTM: Research Fellow
The London School of Hygiene & Tropical Medicine (LSHTM) is a world-leading centre for research and postgraduate education in public and global health. Our mission is to is to improve health and healt...
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Lara Goscé @laragosce.bsky.social · 10/04/2025
Climate-driven migration and displacement and their potential impact on TB in Latin America gh.bmj.com/content/10/4... @cfmcquaid.bsky.social @reinhouben.bsky.social @lshtm-tbmod.bsky.social
gh.bmj.com
Tuberculosis and the climate crisis in Latin America: a predicament of poverty, migration and displacement
Tuberculosis (TB) has long been associated with poverty and displacement, through food insecurity, overcrowding, poor living conditions and reduced access to healthcare, which significantly increase t...
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Katherine Horton @kchorton.bsky.social · 27/04/2025
#Tuberculosis prevention and care relies heavily on international donor funding in many settings. In our latest preprint, we examine the potential impact of reductions in international donor funding for #TB - by the US and by other major donor countries. 1/8 www.medrxiv.org/content/10.1...
medrxiv.org
The potential impact of reductions in international donor funding on tuberculosis in low- and middle-income countries
Background Tuberculosis services in many settings rely heavily on international donor funding. In 2025, the United States Agency for International Development (USAID) was dismantled, and other countri...
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Katherine Horton @kchorton.bsky.social · 09/04/2025
Thanks to co-authors on the #TB analysis @raclark18.bsky.social @cfmcquaid.bsky.social @alexandra-richards.bsky.social @reinhouben.bsky.social @richardwhite321.bsky.social and to John Stover at Avenir Health for pulling it all together. @lshtm-tbmod.bsky.social @tb-lshtm.bsky.social
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Peter MacPherson @petermacp.bsky.social · 02/04/2025
New preprint led by @alexandra-richards.bsky.social & @kchorton.bsky.social from @lightontb.bsky.social Eliminating men’s excess risks for #TB & improving access to treatment to comparable rates to women could have major gains for men, women & children. www.medrxiv.org/content/10.1...
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Rein Houben @reinhouben.bsky.social · 04/04/2025
Very nice analysis showing both potential and challenges of molepi in TB, having to work with samples from small fraction of TB episodes. Highly recommend the read, interesting data and thoughts for debate of targeted vs community-wide screening. But clearly a massive lift by the team, congrats!
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Finn McQuaid @cfmcquaid.bsky.social · 26/03/2025
In 2024, 68 million people were internally displaced by humanitarian crises, & are at increased risk of TB, the world's biggest infectious disease killer. We urgently need estimates to identify the scale of this problem & drive our response. We provide initial numbers here gh.bmj.com/content/10/3...
gh.bmj.com
Thinking fast and slow: the urgency of crisis response must not lead us to overlook chronic needs such as tuberculosis
The number of people facing displacement due to humanitarian crises worldwide is increasing rapidly and is likely to continue. An average 10% year-on-year increase in the last 5 years resulted in 68.3...
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Rein Houben @reinhouben.bsky.social · 20/03/2025
Very exciting to see this out. In many countries and for millions of people with TB, undernutrition is important and tragically 'unmanaged'. There are easy and cheap wins to be had, beautifully laid out by @tbtakenseriously.bsky.social and others. Start measuring, then we can start managing.
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TB Centre LSHTM @tb-lshtm.bsky.social · 17/03/2025
Happening a week today! If attending in person, please register ASAP - tickets are going fast!
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Tom Yates @tomayates.bsky.social · 15/03/2025
NEW COMMENT! TB trials with purely microbiological primary endpoints give greater weight to outcomes that matter most, generalise better to non trial settings, are less biased if regimens differ in duration, and are often better powered #IDSky @catherineberry.bsky.social @sgschumacher.bsky.social
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Rein Houben @reinhouben.bsky.social · 16/03/2025
very nice - add it to the list of ways to re-think how we count TB, and in this case make it simpler.
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Katherine Horton @kchorton.bsky.social · 12/03/2025
A heartbreaking reminder of the public health importance of building trust and relationships with minority communities.
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Rein Houben @reinhouben.bsky.social · 05/03/2025
registration back open after a short break - please join us in person if you can!
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Rein Houben @reinhouben.bsky.social · 27/02/2025
Very happy and proud day - @aschwalbc.bsky.social has passed his PhD viva today with flying colours. Never in doubt, but still a fantastic achievement. Thanks also to co-supervisors @kchorton.bsky.social and Cesar Ugarte-Gil.
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Rein Houben @reinhouben.bsky.social · 25/02/2025
Please spread - exciting opportunity to develop epidemiological and health economic modelling skills as part of exciting project and international team!
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THRU ZIM @thruzim.bsky.social · 25/02/2025
𝗣𝗵𝗗 𝗙𝗲𝗹𝗹𝗼𝘄𝘀𝗵𝗶𝗽 𝗢𝗽𝗽𝗼𝗿𝘁𝘂𝗻𝗶𝘁𝘆! The RADIO-TB trial is offering a @wellcometrust.bsky.social funded PhD in Epidemiology. Based in Zimbabwe & London, this 42-month program focuses on TB management, cost-effectiveness & impact modelling. Apply by 25 March 2025 More info: thruzim.org/opportunities
thruzim.org
OPPORTUNITIES
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Rein Houben @reinhouben.bsky.social · 21/02/2025
Important work led by @cfmcquaid.bsky.social and Matt Saunders. Not as if we need more problems in TB, but pretending that a problem isn't there doesn't help either. Very much worthwhile to think through how climate chance might affect TB, and how we might limit the impact.
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Rein Houben @reinhouben.bsky.social · 17/02/2025
Sign up quickly - exciting day of talks, debates and early career research turbo talks! Follow online or in person, with reception afterwards.
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Rein Houben @reinhouben.bsky.social · 04/02/2025
Great see this project starting. TB survivors face many challenges in health and beyond. Hope we can find a way to solve at least some of these. Exciting collaborations between researchers, care providers and TB survivors across countries and disciplines!
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Kate LeGrand @lekate.bsky.social · 04/02/2025
Hot off the press! 🔥 Our new systematic review digs deep into #TB cluster randomised trials, exploring how contamination can influence results, and offers insights for improving trial design #TBSky #IDSky #MedSky doi-org.ez.lshtm.ac.uk/10.5588/ijtl...
ingentaconnect.com
Contamination effects in cluster randomised trials of TB interven...: Ingenta ConnectBACKGROUNDMETHODSRESULTSCONCLUSION
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Kate LeGrand @lekate.bsky.social · 23/01/2025
Reducing #TB burden requires understanding local contexts. Our new preprint emphasizes the importance of considering social contact patterns for interventions like active case finding, infection prevention & control, & cluster trial design #TBsky #IDsky #GlobalHealth www.medrxiv.org/content/10.1...
medrxiv.org
Within-country heterogeneity in patterns of social contact relevant for tuberculosis infection transmission, prevention, and care
Mycobacterium tuberculosis (Mtb) transmission is driven by variable social, environmental, and biological factors, including the number and duration of indoor contacts. Social contact data can provide...
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Rein Houben @reinhouben.bsky.social · 15/01/2025
Giving food to those in need is both the right and cost-effective thing to do. An honour to work with Anurag and Madhavi Bhargava to further explore the potential of the RATIONS study. Our TB toolbox is expanding, now we must use it!
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Rein Houben @reinhouben.bsky.social · 06/01/2025
Population-wide screening worked in the past, and works now as one of the very few tools we have to really hit TB hard. Beautiful work by @aschwalbc.bsky.social to show how investing now will save many lives, and a lot of money, later. Time to broaden our thinking around screening, and get moving.
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Hannah Rickman @hannahrickman.bsky.social · 03/01/2025
We had high hopes for an #IGRA platform overcoming barriers to use in high #tuberculosis burden settings. Unfortunately it didn't perform as expected, esp in young children #idsky #tbsky shorturl.at/dAcPD Great to work with a fantastic team at Malawi Liverpool Wellcome prog & @lshtm.bsky.social
shorturl.at
Low concordance between QIAreach QuantiFERON-TB, a novel interferon-gamma release assay, and QuantiFERON-TB Gold Plus, in a population-based survey in Blantyre, Malawi
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Jason Andrews @jasonandrews.bsky.social · 26/12/2024
Incarceration is a principal driver of TB in the Americas, but its effects have been underestimated by focusing on cases diagnosed in prisons. The Guardian covered our recent analysis quantifying the full role of incarceration on TB. w/quotes by @juliocroda.bsky.social. led by @yiranliu.bsky.social
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Rein Houben @reinhouben.bsky.social · 23/12/2024
Very good and important work by the team led by @hannahrickman.bsky.social and @petermacp.bsky.social. and 100% agree we need better tools. Unfortunately, not everything we test works. Though that is, in a way, why we test in the first place...
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Finn McQuaid @cfmcquaid.bsky.social · 11/12/2024
Undernutrition is a key driver of TB accounting for 1/5 cases, but relationship is poorly understood. New sys review of this based on 42 studies (>26 million people) by Matt Saunders et al: papers.ssrn.com/sol3/papers.... @reinhouben.bsky.social @raclark18.bsky.social @lshtm-tbmod.bsky.social
papers.ssrn.com
Tuberculosis Incidence and Body Mass Index – An Updated Systematic Literature Review and Global Analysis
Background: Undernutrition is the leading population-level determinant of tuberculosis, but the relationship between tuberculosis and nutritional status remains
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Rein Houben @reinhouben.bsky.social · 10/12/2024
Very nice work led by @laragosce.bsky.social and @cfmcquaid.bsky.social, exploring what adherence technology can do for TB patients, and what it probably cannot do for TB burden. Recommend a read.
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