Introductions to the Rapporteur Organizing Team

Section / Sub-section Programme Secretary

Tobacco Control E. Vidhubala

Tuberculosis Bonnie Mangura

• Bacteriology & Immunology Thomas Shinnick

• Nurses and Allied Professionals Stacie Stender

• Zoonotic TB Francisco Olea-Popelka

• Civil Society Chibuike Amaechi

HIV Wim Vandevelde

Adult & Child Lung Health James Seddon

Overview of Abstracts Session

type Number of

submitted and peer reviewed

Number accepted for presentation

at the conference

Number selected for rapporteur

session Oral

1,384 199 in 28 sessions

Poster 753 in 67 sessions

meetings, plenaries, post-graduate courses, symposia, and workshops were not reviewed

Overview of Abstracts

0

200

400

600

800

1000

1200

1400

Submitted Accepted Reviewed Presented

1384

22199 186

753

436

Poster

Oral

Total

meetings, plenaries, post-graduate courses, symposia, and workshops were not reviewed*

Tobacco Control Tuberculosis Bacteriology & Immunology HIV Adult and Child Lung Health

Greatest Hits in 20 Minutes

Tobacco Control Tuberculosis Bacteriology & Immunology HIV Adult and Child Lung Health

Highlights by E. Vidhubala

How can tobacco control strategies improve HIV and TB outcomes?

• Reinforced the benefits of collaboration between TB, HIV and tobacco control

• Mortality in HIV patients is much higher in smokers than in non-smokers

• Tobacco control & cessation programmes has an impact on TB, need to replicate in HIV

• Global fund cementing the link between HIV and TB, importance of linking tobacco

Educational and behaviour change approaches toward tobacco control: a growing need

• Examples from Belgium, India and Scotland demonstrated the benefits

• Information alone is not sufficient, motivation to change, skills to make and maintain the change and an enabling environment to support the change.

• Do e-cigarettes have a role in harm reduction? • How a variety of e-cigarettes attract millions, not yet proven

to be a safe product? • Nurses as tobacologist - Belgium

Reducing second-hand exposure in the home

• Methodological advances in the measurement of second-hand smoke (SHS) exposure in the home and in motor vehicles in different countries

• The development and evaluation of interventions and policies to reduce SHS exposure in a variety of countries and settings.

Feasibility of supply-side measures for tobacco's endgame

• Define end game • Set multiple strategies • Implement synergistically • Involve stakeholders from many sector • Ultimately, with the leadership of health sector • Ensure an all encompassing approach to taxation, using the

funds for TB, HIV and other tobacco related diseases • Develop our understanding and capacity to use international

treaties and trade agreements to protect public health policies

Working together is the key

• Tobacco control cannot be done in isolation • Less than 1% representation in this platform • Tobacco does not kill on its own • It kills in the form of HIV, TB, Lung diseases,

NCD etc • Tobacco control – whose responsibility

Tobacco Control Tuberculosis Bacteriology & Immunology HIV Adult and Child Lung Health

Highlights by Stacie Stender

Isoniazid, Rifampin, and Pyrazinamide Plasma Concentrations in Relation to Treatment Response in Indonesian Pulmonary

Tuberculosis Patients

Erlina Burhana, Carolien Ruesenb, Rovina Ruslamic, Ginanjar Arum Desiantia, Hadiarto Mangunnegoroa, Purwantyastuti Ascobatd,

Rogier Donderse, Reinout van Crevelb, Rob Aarnoutsef

a. Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Indonesia,

Jakarta, Indonesiaa; Department of Internal Medicine b. Radboud University Medical Centre, Nijmegen, The Netherlands c. Department of Pharmacology and Therapy, Medical Faculty, University of Padjadjaran, Bandung,

Indonesia d. Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Indonesia, Jakarta,

Indonesiad; Department of Epidemiology, Biostatistics and HTA, e. Radboud University Medical Centre, Nijmegen, The Netherlands f. Department of Pharmacy, Radboud University Medical Centre, Nijmegen, The Netherlands

44th Union World Conference

Discussion

Antituberculosis drug concentrations were often low, even with DOTS strategy, but treatment response was nevertheless good

But low pyrazinamide drug concentrations may be associated with a less favorable bacteriological response

No association was shown between plasma concentrations and culture results at 4 and 8 weeks of treatment

LINKAGE OF MDR-TB TO THE SERVICES

KHANN Sokhan, ADN, BBA, MD Senior Consultant for NTP World Health Organization (WHO) Cambodia

TB Cases Registered 19236

Confirmed Presumptive MDR-TB

409 (2%)

Samples reached CC 187 (46%)

Culture Positive 113 (61%)

MTBc

85 (75%)

Confirmed non-presumptive MDR-TB _ 18, 828 (98%)

Could not decide on presumptive MDR-TB status (data inconsistency) _ 4

PDR-TB

2 (2%)

Samples not reached culture center (CC) 222 (54%)

Culture Contaminated 8 (4%)

Culture Negative 66 (35%)

NTM 28 (25%)

Mono DR-TB 12 (15%)

MDR-TB 21 (26%)

PAN Sensitive 47 (57%)

DST Contaminate _ 3 (4%)

Initiated on MDR-TB treatment 21 (100%)

Figure 11/01/2013

PC-643-02 Clinical characterization of symptomatic patients with non-tuberculous mycobacteria in

Zambia prisons E Turnbull, M Siyamabango, K Kaunda, C Chileshe, I Dunn, S Reid, G Henostroza • 1458 inmates screened Jan-Apr 2011 • M. tuberculosis isolated in 56 (3.8%) • NTM isolated in 80 (5.4%). Of

– 15 HIV-positive, 8 previous history of TB. – Species identified: 51 M. fortuitum, 5 M. intracellulare, 2 M.

abscessus, 1 M. gordonae, 1 M. scrofulaceum, 20 unknown. • 8% of individuals had 1 or moreTB symptom, 30% had abnormal

CXR, and 8% were clinically diagnosed with TB.

Advice about contraception to female tb patients and ltbi patients

Oda van de Waarsenburg, RN PHS VGGM, Arnhem San Borkus, RN PHS Gooi en Vechtstreek, Bussum Connie Erkens, KNCV Tuberculosis Foundation Maruschka Şebek Netherlands 3 November 2013

Questionaire

What advice do you give? (several answers are possible)

nurses physicians

Carl Morrow, Samuel Ginsberg, Elizabeth Piccoli, Keren Middelkoop and Robin Wood

With acknowledgements to Jason Andrews, Darryl Kalil, Angelina Sassi

HIV CENTRE

Quantification of shared air; an innovative technology platform to

measure potential TB transmission.

Travel Funding to CM from NRF (South Africa)

0

200

400

600

800

1000

1200

Net

CO

2 (pp

m)

Time OP-144-01 Place Number of Minutes Litres of Rebreathed AirAmphithéâtre bleu 476 69.99Palais Passages 100 5.37Hotel 316 1.04Pavement Cafe 35 0.65Outdoors 78 0.00Sleeping 434 0.00Total 1439 77.06

Mass public transportation and tuberculosis in a high incidence setting

C Zamudio1, F Krapp1, H Choi2, L Shah3, A Ciampi3, E Gotuzzo1, J Heymann4, C Seas1, T Brewer 4

‡

1 Universidad Peruana Cayetano Heredia. Perú, 2 Johns Hopkins University. USA, 3 McGill University. Canada, 4 University of California, Los Angeles. USA

Results multivariate analysis

Variables Adjusted

OR

95% Conf.

Interval p

Age > 50 years old

0.19

0.04 - 0.97

0.046

House income > 1000 soles 0.18 0.05 - 0.62 0.006

Mass transportation to work 11.8 1.45 - 96.07 0.021

Household contact 26.37 3.98 - 174.72 0.001

Workplace contact 2.43 0.43 - 13.56 0.312

Tobacco Control Tuberculosis Bacteriology & Immunology HIV Adult and Child Lung Health

Highlights by Thomas Shinnick

Bacteriology & Immunology

• OP-103-01 Costs of the Xpert MTB/RIF from patients' perspective in Manaus, Northern Brazil. Antunes, Pinto, Menezes, Trajman

• From patient perspective Xpert is less costly than smears for TB diagnosis in Manaus – mainly because of fewer visits

Test Direct Cost

Indirect cost

Total pt cost

Smear $13.02 $12.40 $25.24 Xpert $9.27 $6.51 $16.44

Bacteriology & Immunology • OP-112-01 Same-day microscopy improves TB

diagnosis – Uganda. Chaisson et al.

• OP-114-01 Same-day microscopy less effective for TB diagnosis - India. Nayak et al.

Method %return %AFB+ %treated Spot-spot 96% +7.8% 76% Spot-morning 75% +9.9% 58%

Method %return Yield 2nd %AFB+ Spot-spot 93% +4% 14.1% Spot-morning 96% +20% 16.9%

Bacteriology & Immunology • OP-242-02 MDR/XDR-TB colour test results

predict TB outcomes. Wendell, Herrera, Ramos, Tovar, Schumacher, Valencia, Coleman, Evans

Bacteriology & Immunology

• PC-505-01 High proportion of fluoroquinolone monoresistant M. tuberculosis strains in Pakistan, 2010-2012. Jabeen, Malik, Hasan

• 2029 MDR strains and 3012 non-MDR strains

M.tb %FQ-R %FQ-mono-R Strains 2010 2012 2010 2012 MDR 54.6% 57.4% -- --

non-MDR 10.3% 19.3% 6% 11.3%

Tobacco Control Tuberculosis Bacteriology & Immunology HIV Adult and Child Lung Health

Highlights by Stacie Stender

Diagnosis of HIV-Associated TB in Hospital In-Patients:

Spit or Pee?

STEPHEN D. LAWN, Andrew D. Kerkhoff, Rosie Burton, Charlotte Schutz, Gavin van Wyk, Monica Vogt, Pearl

Pahlana, Mark Nicol, Graeme Meintjes

Rapid screening for TB in HIV-infected medical in-patient admissions in South Africa: massive incremental yield using

a novel urine-based diagnostic strategy (interim analysis)

0.9%

10.0%

10.9%

19.1%

20.0% 18.2% 20.9%

Urine samples 69.1%

Other samples

Sputum samples Breakdown of all TB diagnoses (n=110)

Intensified TB Case Finding in a Cohort of HIV-infected Children in Johannesburg, South Africa S. Sawry, H. Moultrie, T. Mnisi, A. Kubheka, M. Mokoatle, A. Van Rie 44th Union World Conference – Abstract OP-125-01 1st November 2013

Conclusions In this cohort of young South African children we found a low prevalence of positive TB screens despite the use of a highly sensitive TB symptom screen

Almost half of the children were excluded because they were on TB treatment at time of initiating ART - may explain the low prevalence of TB symptoms of baseline The protective effect of ART through immune reconstitution may explain the low incidence of positive TB screens in young children on ART

Few children with a positive screen initiated TB treatment.

Only 5 of the 71 positive symptom screens resulted in a decision to start treatment Of these, 1 children started solely on clinical suspicion, 3 based on suggestive CXR and 1 based on a positive culture result

PC-318-01: Demography and not HIV predicts active TB in a community sample in

rural South Africa S Shenoi, A Moll, TK Kompala, RP Brooks, U Lalloo, L Andrews, G Friedland

• TB-HIV screening at community congregate settings (n=5457) – Sputum for microscopy, culture and DST in

symptomatic individuals • 35 cases of microbiologically confirmed

TB equivalent to 641 / 100 000 case notification rate

Preliminary Report on the First TB-DOT Program Integrated into Methadone Treatment for Heroin Injectors with TB in Sub-Sahara Africa

R. Douglas Bruce, MD, MA, MSc Sheela Shenoi, MD, MPH Sarah McAlister Jessie Mbwambo, MD Ibrahim Mtzea, MD Cassian Nyandindi, MD Barrot Lambdin, PhD Gerald Friedland, MD

Results • 51 patients (40 men) received standard first

line treatment with their methadone. – Mean age 34 (range 24-49)

• 30/51 (59%) have finished TB treatment with 13/51 (25%) still on treatment.

• Only 3/51 (6%) defaulted • 5/51 died (10%), all of whom had HIV.

• 38/51 (75%) were HIV co-infected – 32/38 (84%) were on HIV therapy.

11/07/2013 37

HIV testing among presumptive TB cases in routine implementation, Karnataka, India

Dr. Balaji Naik,

Medical Consultant, RNTCP Technical Assistance Project World Health Organization, Country Office for India

naikb@rntcp.org, www.tbcindia.nic.in

Co-authors: AMV Kumar, A Kanchar, MK Tripathi, MD Suryakant , KG Deepak, P Bhat, C Rangaraju, A Harsha, S Nair

RNTCP Laboratory Register

Tobacco Control Tuberculosis Bacteriology & Immunology HIV Adult and Child Lung Health

Highlights by James Seddon

Adult and Child Lung Health

• B Padhi (OP-213-02) • Rural India • Girls aged 10-15 years

– Exposed to HAP = 785 – Non-exposed = 743

• Spirometry • Girls exposed to HAP

– Lower PEF, FVC and FEV₁ (p<0.05)

Adult and Child Lung Health • V Mahamba (OP-262-03) • Child TB guidelines

introduced and comprehensive training 2010 – 2013

• 49 trainers and 481 healthcare workers trained

• Increased numbers – Children suspected – Children screened – Children diagnosed

Adult and Child Lung Health

• R Pathak (OP-205-02) • Bihar, India • 7 selected NRCs • July – Sept 2012 • 440 malnourished

children • 8.9% confirmed or

probable TB • Only 46% reported to

NTP

Initiated on TB Treatment n = 34 (87.2%)

SAM children admitted to NRC N=440

Diagnosed with TB n = 39 (8.9%)

Screened for TB n = 314 (71.4%)

Not initiated on TB Treatment n = 5 (12.8%)

Registered with RNTCP n = 18 (52.9%)

Not Registered with RNTCP n = 16 (47.1%)

Adult and Child Lung Health • H S Schaaf • (OP-133-01) • 5th prospective

surveillance period (2011-2013)

• 324 children with culture-confirmed TB

• HIV 15.7% • MDR-TB 4.6%

Adult and Child Lung Health

• L Verhagen (PC-588-02) • Orinoco Delta, Venezuela • Aug – Nov 2012 • 229 children <2 years • 26% helminth infection • 59% protozoal infection • Recurrent wheeze associated with

protozoal infection (p=0.02)

Adult and Child Lung Health • D Paresh (PC-818-03) • DOT not permitted by parent in India • June – Sept 2012 • 30 districts of Gujarat state

– 15 districts - Family DOT – 15 districts – Non-family DOT

• 624 children registered • Treatment success

– 95% family DOT – 93% non-family DOT – (p=0.15)

Thank You to the Session Chairs who provided feedback

Wayne van Gemert Mary Edginton Harry Hausler Armand Van Deun Carrie Tudor Siphiwe Ngwenya Chibuike Amaechi Salome Charalambous Stacie Stender Ritta Dlodlo ID Rusen Rajita Bhavaraju Wim Vandevelde Christopher Kuaban Xiaolin Wei Colleen Daniels Anna Mandalakas Pranay Lal Robert Colebunders Chinwe Owunna Tara Singh Bam Harry Hausler Lee Reichman Dominique Lagarde Sharon Nachman Stacie Stender Richard Zaleskis Jeffrey Starke Linsey E. Stewart-Isherwood Merete Taksdal Guy Marks Stella van Beers Chen-Yuan Chiang Stephen M. Graham Marina Shulgina Nestan Tukvadze Anne Jones Rumina Hasan Martin van den Boom Bonita Mangura Leen Rigouts Petra Stankard Akira Shimouchi Thomas Shinnick Matsie Mphahlele Kevin Schwartzman Anna Scardigli Alexander Golubkov D'Arcy Richardson Wim vandevelde Pierpaolo de Colombani Paula Fujiwara Ya Diul Mukadi Keren Middelkoop Richard Chaisson Erica Lessem Joan Nyamu Barnet Nyathi Luis Cuevas Thomas Stuebner P. Fujiwara Chibuike Amaechi Amos Omoniyi Andrew Steenhoff Helene Wallstedt Adrian Muwonge