Matthew Saunders

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...

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.

“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...

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/...

“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...

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...)

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.

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...)

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/...

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.

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/...

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.

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....