1/📢 In our new PREPRINT - http://tinyurl.com/yc6kbay9 - we estimate that 156 million people globally carry a recent, viable M. tuberculosis (Mtb) infection and are at high risk of progressing to TB disease.
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Beautiful piece of work, years in the making. Very proud to see Alvaro lead this work, taking the discussions around Mtb infection away from the highly flawed foundation of 'immunoreactivity = infection', and build in mixing, reversion and self-clearance. Many congrats @aschwalbc.bsky.social
2/ A previous study estimated that a quarter of the global population had a 'latent' TB infection - http://tinyurl.com/2ap23d6k. However, this estimate essentially reflects individuals exposed to Mtb and still exhibiting immunoreactivity, rather than viable Mtb infection.
3/ Recent insights into the natural history of TB warrant a more accurate estimate of the global burden of viable Mtb infection. Our approach extends the methods of the 2016 paper by including key new insights around reversion, age-specific mixing patterns and self-clearance.
4/ Firstly, we adjusted annual infection risk (ARI) trends for immunoreactivity reversion and age-based social mixing to address ARI underestimation, offering a more accurate infection force estimate.
NOT YET PEER-REVIEWED.
5/ Secondly, we also account for the evidence that many individuals may self-clear Mtb infection, calibrating these rates using data from @kchorton.bsky.social et al. - http://tinyurl.com/ykap23kx - on infection and disease pathways in a simulated cohort.
6/ Thirdly, we focused on recent infections, acknowledging that the highest risk of progression to disease occurs within the first two years since infection.
7/ By integrating these insights, our model generated estimates for 171 countries (covering 99.6% of the world population), all six WHO regions, and globally.
NOT YET PEER-REVIEWED
Comments
Beautiful piece of work, years in the making. Very proud to see Alvaro lead this work, taking the discussions around Mtb infection away from the highly flawed foundation of 'immunoreactivity = infection', and build in mixing, reversion and self-clearance. Many congrats @aschwalbc.bsky.social
NOT YET PEER-REVIEWED.
NOT YET PEER-REVIEWED