Rein Houben
@reinhouben.bsky.social
Professor of Tuberculosis Epidemiology @LSHTM - TB nerd
Reposted by Rein Houben
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...
www.thelancet.com/journals/lan...
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...
www.thelancet.com
October 31, 2025 at 9:12 AM
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...
www.thelancet.com/journals/lan...
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.
“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...
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...
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...
www.thelancet.com
October 28, 2025 at 7:05 PM
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.
Reposted by Rein Houben
“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...
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...
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...
www.thelancet.com
October 28, 2025 at 9:44 AM
“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...
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...
Reposted by Rein Houben
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/10.1371/jour...
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...
doi.org
October 20, 2025 at 6:47 PM
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/10.1371/jour...
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.
October 16, 2025 at 7:18 AM
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.
Reposted by Rein Houben
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
bit.ly/4nbV492
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...
www.medrxiv.org
October 12, 2025 at 12:51 PM
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
bit.ly/4nbV492
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...
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...
www.medrxiv.org
October 7, 2025 at 9:17 AM
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...
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.
Our work on modelling population-wide screening in Viet Nam is now available in PLOS Global Public Health! tinyurl.com/3ymhuj5s
September 11, 2025 at 7:26 AM
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.
Reposted by Rein Houben
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
September 10, 2025 at 8:18 AM
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
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.
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/...
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
doi.org
September 9, 2025 at 9:00 AM
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.
Reposted by Rein Houben
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
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
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...
www.medrxiv.org
August 27, 2025 at 2:55 PM
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
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
Reposted by Rein Houben
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/3TDl28T
@raclark18.bsky.social @cfmcquaid.bsky.social @alexandra-richards.bsky.social @top-j.bsky.social @reinhouben.bsky.social @richardwhite321.bsky.social
July 14, 2025 at 8:46 AM
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/3TDl28T
@raclark18.bsky.social @cfmcquaid.bsky.social @alexandra-richards.bsky.social @top-j.bsky.social @reinhouben.bsky.social @richardwhite321.bsky.social
Reposted by Rein Houben
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
doi.org/10.1016/S221...
@lshtm-tbmod.bsky.social @tb-lshtm.bsky.social
July 4, 2025 at 11:25 AM
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
doi.org/10.1016/S221...
@lshtm-tbmod.bsky.social @tb-lshtm.bsky.social
Reposted by Rein Houben
TB seems to comprehensively disrupt the normal physiological progression of puberty.
academic.oup.com/jid/advance-...
academic.oup.com/jid/advance-...
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
academic.oup.com
June 3, 2025 at 5:21 AM
TB seems to comprehensively disrupt the normal physiological progression of puberty.
academic.oup.com/jid/advance-...
academic.oup.com/jid/advance-...
Reposted by Rein Houben
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...
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...
www.who.int
May 30, 2025 at 8:30 AM
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...
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.
May 27, 2025 at 2:50 PM
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.
Reposted by Rein Houben
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...
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...
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...
jobs.lshtm.ac.uk
May 16, 2025 at 3:05 PM
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...
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...
Reposted by Rein Houben
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
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...
gh.bmj.com
April 10, 2025 at 1:59 PM
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
Reposted by Rein Houben
#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...
www.medrxiv.org/content/10.1...
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...
www.medrxiv.org
April 27, 2025 at 6:16 AM
#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...
www.medrxiv.org/content/10.1...
Reposted by Rein Houben
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
@lshtm-tbmod.bsky.social @tb-lshtm.bsky.social
April 9, 2025 at 8:32 AM
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
@lshtm-tbmod.bsky.social @tb-lshtm.bsky.social
Reposted by Rein Houben
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...
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...
April 2, 2025 at 8:06 PM
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...
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...
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!
Distribution and transmission of
#tuberculosis in a high-HIV prevalence city
in Malawi: A genomic and spatial analysis 🛟🧪
journals.plos.org/globalpublic...
@uofgshw.bsky.social @jasonandrews.bsky.social @rachaelburke.bsky.social @jsalomon.bsky.social
#tuberculosis in a high-HIV prevalence city
in Malawi: A genomic and spatial analysis 🛟🧪
journals.plos.org/globalpublic...
@uofgshw.bsky.social @jasonandrews.bsky.social @rachaelburke.bsky.social @jsalomon.bsky.social
April 4, 2025 at 6:52 AM
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!
Reposted by Rein Houben
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...
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...
gh.bmj.com
March 26, 2025 at 10:02 AM
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...
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.
Undernutrition is the leading risk factor for TB globally, so its very exciting to see this roadmap for integrating nutrition into the care of people with TB out now in @lancetgh.bsky.social, led by the amazing @tbtakenseriously.bsky.social
www.sciencedirect.com/science/arti...
www.sciencedirect.com/science/arti...
A roadmap for integrating nutritional assessment, counselling, and support into the care of people with tuberculosis
Undernutrition—the leading risk factor for tuberculosis worldwide—is associated with impaired immunity, more extensive disease, delayed sputum convers…
www.sciencedirect.com
March 20, 2025 at 3:05 PM
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.
Reposted by Rein Houben
Happening a week today! If attending in person, please register ASAP - tickets are going fast!
March 17, 2025 at 9:23 AM
Happening a week today! If attending in person, please register ASAP - tickets are going fast!