Information system for tuberculosis

Indonesia, with one of the world’s highest TB burdens, relies on SITB to track and manage tuberculosis cases nationwide. This study thoroughly evaluated SITB through a multimethod approach that included heuristic evaluation, user satisfaction surveys, and in-depth interviews with health workers.

The heuristic evaluation revealed multiple usability issues, most notably inconsistent terminology, inadequate error prevention, and interface design flaws that could hamper efficient reporting. Among these, limited data entry capability due to server constraints was a critical limitation affecting system performance during busy hours.

User satisfaction measured through the EUCS model showed generally positive perceptions, with an average satisfaction score of 4.08. However, dimensions like ease of use and timeliness fell below optimal levels. Users reported frustration over the slow response time and difficulties learning to use the system without formal training.

Qualitative interviews further illuminated operational challenges. Although recent integration with the civil registration system (Dukcapil) improved data completeness and reduced some manual work, users still had to enter duplicate information into separate systems, highlighting the need for seamless EMR integration.

The study emphasizes that while SITB has significantly modernized TB reporting in Indonesia, its full potential will only be realized through targeted enhancements—especially improving system performance, refining user support materials, and completing integration with EMR platforms.

These findings will serve as a roadmap for policymakers and system developers aiming to optimize SITB’s functionality and support Indonesia’s TB elimination goals by 2030.

Source:

1. Pratiwi, R.D., Alisjahbana, B., Subronto, Y.W., Priyanta, S. and Suharna, S., 2025. Implementation of an information system for tuberculosis in healthcare facilities in Indonesia: evaluation of its effectiveness and challenges. Archives of Public Health, 83(1), pp.1-18.

Syndemic of TB and diabetes

Tuberculosis and diabetes mellitus have emerged as a syndemic, with each condition exacerbating the other. Patients with both diseases experience diagnostic challenges, as diabetes can significantly delay TB diagnosis and treatment initiation. For example, studies in China demonstrate a fourfold longer median time from symptom onset to first healthcare contact among people with diabetes. Although some reports suggest quicker treatment initiation, the weight of evidence supports delayed diagnosis as a common scenario.

Clinical presentations in patients with concurrent TB and diabetes are frequently more severe. These include disseminated disease, cavitary lesions, and atypical radiographic features that can further complicate diagnosis and management. Poor glycemic control correlates with worse disease severity, underscoring the need for meticulous monitoring of glucose levels throughout TB treatment. Notably, many patients without prior diabetes can develop transient hyperglycemia during therapy, raising questions about optimal screening and retesting intervals.

Treatment outcomes are consistently poorer in patients with diabetes. These individuals have higher mortality rates, greater risks of relapse, longer times to sputum conversion, and increased likelihood of multidrug-resistant TB. The interplay between diabetes and TB medications, along with the higher pill burden, increases the risks of adverse effects and treatment interruptions. Furthermore, hyperglycemia, whether transient or chronic, predicts worse TB outcomes, pointing to a complex interaction beyond simple glucose elevation.

At the biological level, M. tuberculosis infection of adipose tissue may drive metabolic disruptions that mimic the inflammatory state seen in insulin resistance. This mechanistic link provides a plausible explanation for the bidirectional relationship between TB and dysglycemia. Diabetes impairs both innate and adaptive immunity against TB, compromising the host’s ability to clear infection and leading to higher bacterial loads.

Emerging evidence suggests that certain diabetes medications, such as metformin and statins, may exert beneficial effects on TB immunopathology, independent of their glucose-lowering properties. However, corticosteroids and some TB treatments may worsen hyperglycemia, necessitating careful therapeutic balancing. There is a clear need for rigorous studies, including randomized controlled trials and standardized registries, to clarify these interactions and optimize treatment strategies.

Overall, the syndemic of TB and diabetes requires integrated management approaches that address not only microbial eradication but also metabolic and immunological dysfunction. Enhanced screening, prompt diagnosis, tailored treatment regimens, and close glycemic monitoring will be crucial to improving outcomes in this vulnerable population.

Source:

1. Magodoro, I., Kotze, L., Stek, C.J., West, A., Le Roux, A., Sobratee, N., Taliep, A., Hamada, Y., Dave, J.A., Rangaka, M.X. and Parihar, S.P., 2025. Clinical, metabolic and immune interaction between tuberculosis and diabetes mellitus: implications and opportunities for therapies. Expert Opinion on Pharmacotherapy.

Tuberculosis in the Philippines

BPaL Regimen Costs [2]

A research sought to fill a knowledge gap about the real-world economic burden of BPaL, a WHO-endorsed treatment for DR-TB, in the Philippines. By analyzing patient and provider costs using rigorous economic evaluation methods, the study found that BPaL substantially reduces direct and indirect costs for patients. The use of patient surveys and financial reviews allowed for detailed cost capture, adding strength to the cost-effectiveness conclusions.

Crucially, BPaL not only demonstrated lower costs but also superior treatment success rates compared to current regimens. These results are especially impactful given the high burden of DR-TB in resource-constrained settings like the Philippines. The study's robust design — including standardized patient selection and multiple data sources — supports its credibility.

From a policy perspective, the data suggest that transitioning DR-TB treatment toward the BPaL regimen could improve both patient outcomes and economic efficiency. Lower healthcare visits and reduced catastrophic expenditures further emphasize its advantage in practical, real-world implementation.

The economic analysis, including favorable ACER and ICER values under established GDP thresholds, clearly supports the adoption of BPaL. With cost and health advantages converging, the study makes a strong case for the national TB program to prioritize BPaL in routine care beyond the operational research context.

Outpatient DM Costs [1]

In 2021, diabetes mellitus (DM) outpatient visits accounted for 3% to 13% of total outpatient visits across 11 study sites in the Philippines. The study assessed various unit costs associated with DM services, including risk assessments at USD 0.53 and screenings using fasting blood sugar (FBS) at USD 2.99 when conducted with a chemistry analyzer. Random plasma glucose (RPG) screenings were slightly lower, costing USD 1.67, while the oral glucose tolerance test (OGTT), offered in only one private hospital, had the highest cost at USD 23.72. HbA1c testing was available in select facilities, further contributing to screening and diagnostic costs.

The weighted mean monthly drug cost per DM patient was estimated at USD 7.67, with metformin costing USD 2.11 per month and gliclazide ranging from USD 2.92 to USD 3.22, depending on dosage. Among injectable drugs, biphasic isophane human insulin was the most commonly prescribed, with an average monthly cost of USD 29.45. Staff time was the primary cost driver for outpatient services not requiring laboratory tests, accounting for 70% to 92% of costs, while consumables made up 52% to 90% of the expenses for screening and diagnosis services.

The cost per DM case detected among TB patients was lowest when using the RPG plus FBS algorithm at USD 17.43 per case, and HbA1c plus FBS at USD 25.41. When screening was limited to patients aged over 45 years, these costs decreased to USD 11.73 and USD 16.17 per case, respectively. Overall, the monthly cost per DM outpatient ranged from USD 8.95 for drug prescriptions alone to USD 12.36 when monitoring and consultations were included. These findings provide essential data to inform planning and budgeting for integrated TB-DM care, although further research is needed to explore inpatient costs and the patient perspective.

References:

1. Yamanaka, T., Castro, M.C., Ferrer, J.P., Solon, J.A., Cox, S.E., Laurence, Y.V. and Vassall, A., 2024. Health system costs of providing outpatient care for diabetes in people with TB in the Philippines. IJTLD open, 1(3), pp.124-129.
2. Evans, D., Hirasen, K., Casalme, D.J., Gler, M.T., Gupta, A. and Juneja, S., 2024. Cost and cost-effectiveness of BPaL regimen used in drug-resistant TB treatment in the Philippines. IJTLD open, 1(6), pp.242-249.

Tackling The Spread

1. Structural & Environmental Drivers of TB Spread

• Overcrowding and poor prison conditions (e.g., Lhokseumawe Prison at 400% capacity) significantly increase TB transmission risk.
• Housing conditions, like inadequate ventilation and high density, though intuitively risky, showed no direct statistical link in one study—but malnutrition was strongly associated with TB incidence (OR ≈ 4.6).
• Climate variables (minimum temperature, rainfall) in Brunei showed delayed but significant links to TB incidence, suggesting environmental factors may indirectly drive TB via behavior or immunity shifts.
• Feasible interventions: Decongest prisons and improve inmate health screenings. Address nutrition systematically in vulnerable communities and facilities. Incorporate climate-related surveillance in TB forecasting in tropical areas.

See also: Lin TB Lab NTU

---

2. Biological and Comorbidity Risk Factors

• Comorbidities, especially diabetes, are major risk amplifiers for TB (Odds Ratios > 5).
• In Brunei, 33.9% of TB patients had diabetes, with older age, renal disease, and hypertension also significantly linked.
• SGLT2 inhibitors (e.g., dapagliflozin, empagliflozin) in diabetic TB patients showed substantial mortality reductions—up to 92% lower one-year mortality in high-dose users.
• Feasible interventions: Integrate diabetes screening and management in TB control programs. Investigate and consider off-label use or trials of SGLT2-i for comorbid TB-DM patients in high-burden areas.

See also: BMRC Indonesia

---

3. Social Determinants & Stigma

• Stigma (internal and external) leads to delayed care, treatment dropouts, and isolation.
• Internal shame and societal rejection were consistent across Southeast Asian studies.
• TB is reinforced as a "disease of poverty", with low-income communities bearing the heaviest burdens.
• Feasible interventions: Design community-based anti-stigma campaigns and peer support systems. Tackle structural poverty and improve healthcare access as part of TB elimination strategies.

---

4. Innovation Gaps in Diagnostics, Vaccines, and Surveillance

• Diagnostic and vaccine tools are decades outdated (e.g., BCG, Mantoux).
• WHO’s End TB goals are faltering—only 1.5% annual incidence reduction vs. 10% target.
• Promising tools: Xpert Ultra, QuantiFERON for better diagnostics. Genomic sequencing and PET/CT imaging show promise but are costly.
• Feasible interventions: Scale up use of WHO-recommended molecular diagnostics. Build national capacity for TB surveillance and genomics, especially in LMICs.

---

5. Research, Policy, and System Reform

• Top-down global TB strategies need restructuring.
• Emphasis on local leadership, reduced red tape, and context-sensitive research models.
• Cohort studies (Brunei, Taiwan, Aceh) show the value of real-world, data-driven insights into localized TB risks.
• Feasible interventions: Support local TB program autonomy with funding and technical support. Encourage collaborative research hubs in high-burden regions. Align national policies with WHO’s integrated TBDM framework and climate-health surveillance insights.

Yoseph Leonardo Samodra

References:

1. Khairunnisa C, Mardiati, Millizia A, Wahyuni S, Nabilah Lubis P, Ikhsan M. Risk Factors for Pulmonary Tuberculosis Transmission Among Prisoner in Correctional Facilities in Lhokseumawe City, Aceh, Indonesia. Natl J Community Med 2025;16(6):582-588.
2. Pradana, T.L.C., Putra, B.T.W. and Utami, W.S., 2025. Stigma Tuberkulosis Paru di Asia Tenggara: Systematic Literatur Review. MAHESA: Malahayati Health Student Journal, 5(6), pp.2501-2512.
3. Syahrani, F., Lestari, H. and Irma, I., 2025. Faktor Risiko Kejadian TBC pada Usia Produktif di Puskesmas Poasia, Kota Kendari Tahun 2024. Jurnal Kendari Kesehatan Masyarakat, 4(3), pp.221-229.
4. Wright K. Tackling Tuberculosis: The Current Landscape and Future Directions. EMJ Microbiol Infect Dis. 2025;6[1]:26-30.
5. Lee, C.S., Ho, C.H., Liao, K.M., Wu, Y.C. and Shu, C.C., 2025. The impacts of SGLT2 inhibitors on the mortality of patients with tuberculosis. Journal of Infection and Public Health, p.102686.
6. Omar, N., Wong, J., Thu, K., Alikhan, M.F. and Chaw, L., 2021. Prevalence and associated factors of diabetes mellitus among tuberculosis patients in Brunei Darussalam: a 6-year retrospective cohort study. International Journal of Infectious Diseases, 105, pp.267-273.
7. Chaw, L., Liew, S.Q. and Wong, J., 2022. Association between climate variables and pulmonary tuberculosis incidence in Brunei Darussalam. Scientific Reports, 12(1), p.8775.

TBC 065

Tuberculosis in Lombok

A study investigating the treatment adherence of tuberculosis (TB) patients in East Lombok utilized a questionnaire grounded in the Health Belief Model (HBM) as its primary instrument. The questionnaire was designed to assess six key components: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. Responses were recorded using a 5-point Likert scale, ranging from “strongly disagree” to “strongly agree.” The study included 112 TB patients, most of whom were male (57.1%) and aged over 50 (44.6%). A significant portion of participants were smokers (41.1%), while alcohol use was minimal (8.9%). Educational levels were generally low, with 35.7% having only completed primary education, and unemployment was common among respondents (40.2%).

The findings revealed that most participants held moderate perceptions of vulnerability (44.6%) and seriousness (53.6%) regarding TB. Similarly, 49.1% had moderate perceptions of treatment benefits, while 40.2% reported relatively low perceived barriers. Half of the participants (50.9%) reported receiving external support, categorized as cues to action, and 31.3% exhibited low self-efficacy. In terms of health behaviors, 58% of TB patients were adherent to their treatment regimens, whereas 42% were not. Statistical analysis indicated that perceived susceptibility (p = 0.022) and perceived benefits (p = 0.006) were positively associated with adherence. Patients with high perceived susceptibility were 1.617 times more likely to adhere to treatment. On the other hand, perceived barriers (p = 0.045) were negatively associated with adherence, reducing the likelihood of adherence by 31.6%. Additionally, cues to action (p = 0.004) and self-efficacy (p = 0.009) also had significant positive effects.

While the results offer valuable insights, the study’s cross-sectional design limits the ability to infer causality between HBM components and TB-related health behaviors. Furthermore, reliance on self-reported data introduces the possibility of social desirability bias, where participants may have provided responses they deemed more socially acceptable. Despite these limitations, the study highlights the importance of addressing both psychological and contextual factors to improve TB treatment adherence. Interventions that strengthen positive perceptions and reduce barriers—while being sensitive to local cultural and social realities—may lead to more effective public health strategies in regions like East Lombok.

Source: Suprijandani, S., Setiawan, S., Pathurrahman, P., Wardoyo, S. and Rahayyu, A.M., 2025. The behaviour of TB patients in East Lombok through a health belief model approach. Journal of Health, Population and Nutrition, 44(1), p.23.

Development of COPD after a TB episode

Several studies have shown that people who recover from tuberculosis (TB) often experience lasting airway obstruction or ongoing respiratory symptoms. In China alone, around 100 million individuals are estimated to have chronic obstructive pulmonary disease (COPD), making up nearly a quarter of the global COPD burden. This study used data from the CHERRY cohort, an electronic health database covering 98% of adults in Yinzhou District, to explore the long-term impact of TB on COPD development. We included participants over 35 years of age and excluded anyone diagnosed with TB after a COPD diagnosis.

Tuberculosis cases were identified using the national disease reporting system and defined through ICD-10 codes. Similarly, COPD diagnoses were captured through the same coding system. Once someone was diagnosed with COPD, they no longer contributed to follow-up. The main analysis measured the time between enrollment (or TB diagnosis, if it occurred later) and the earliest of three events: COPD diagnosis, death, or the end of the study in September 2021. We compared COPD incidence in people with and without TB using Poisson tests and adjusted for various factors through three multivariable models.

The study enrolled nearly 200,000 individuals, with a median age of 46.5 years and an even gender distribution. During nearly 10 years of follow-up, over 16,000 developed COPD, including 23.6% of those with prior pulmonary TB. In contrast, the overall COPD incidence was 8.3%. After adjusting for age, lifestyle factors, comorbidities, and medication use, pulmonary TB remained a strong predictor of future COPD. The hazard ratios ranged from 2.63 in minimally adjusted models to 1.77 in fully adjusted models. This association was especially strong in older adults and those with lower educational attainment.

Importantly, the increased COPD risk remained even after accounting for smoking status, alcohol use, and physical activity, and the results were consistent across sensitivity analyses. These findings highlight the long-term respiratory consequences of TB and suggest that a history of TB should be considered a key risk factor when evaluating COPD risk. Preventing TB may not only reduce TB-related morbidity but also offer additional benefits in lowering COPD rates in the general population.

Source: 

1. Wang, J., Yu, L., Yang, Z., Shen, P., Sun, Y., Shui, L., Tang, M., Jin, M., Chen, B., Ge, Y. and Lin, H., 2025. Development of chronic obstructive pulmonary disease after a tuberculosis episode in a large, population-based cohort from Eastern China. International journal of epidemiology, 54(2), p.dyae174.

Tuberculosis in Spain

A study addresses the impact of exposure time to pulmonary tuberculosis (TB) on the risk of transmission among contacts in Catalonia, Spain. By examining over 7,000 individuals exposed to 847 TB cases, the researchers found a clear association between longer daily exposure and increased TB risk. Those exposed for more than 6 hours a day had nearly 7 times the risk of developing TB compared to those exposed less than 6 hours a week.

Particularly vulnerable groups included children under 5 years, who were over eight times more likely to develop TB, and immigrants, who had nearly double the risk compared to non-immigrants. Although smoking showed an increased risk, the association wasn't statistically significant. These findings suggest that exposure time is a critical determinant in TB transmission, reinforcing the need for timely and focused contact investigations.

Importantly, the research emphasizes the value of integrating TB screening into routine primary care systems, particularly for high-risk populations. By tailoring public health strategies to exposure time and personal risk factors, TB control programs can become more efficient and effective.

Source: Godoy, S., Parrón, I., Millet, J.P., Caylà, J.A., Follia, N., Carol, M., Orcau, A., Alsedà, M., Toledo, D., Plans, P. and Ferrús, G., 2024. Risk of tuberculosis among pulmonary tuberculosis contacts: the importance of time of exposure to index cases. Annals of Epidemiology, 91, pp.12-17.

Triglyceride-glucose Index and Risk of TB Infection

A study aimed to evaluate how the triglyceride-glucose (TyG) index and its related parameters correlate with the risk of latent TB infection in adults, considering different states of glucose metabolism. Drawing from the NHANES 2011–2012 data, researchers analyzed 4823 participants after strict exclusion criteria. The TyG index was calculated alongside its derived markers (TyG-WC, TyG-BMI, TyG-WHtR), and TB infection was assessed using standard diagnostic tests.

The results revealed that individuals with normal glucose tolerance (NGT) and those with impaired glucose tolerance (IGT) had significantly higher odds of TB infection when TyG index values were elevated. Particularly in the NGT group, even modest increases in TyG values were linked to a notable rise in TB risk. In contrast, no significant relationship was found between TyG markers and TB infection in people with diabetes (DM) or impaired fasting glucose (IFG).

While the findings support TyG as a potential early marker of TB susceptibility in metabolically healthier adults, the study design limits causal inferences. Additionally, the extremely high odds ratios in some subgroups call for careful interpretation and further research to confirm these patterns and understand the underlying mechanisms.

Source: Qi, M., Qiao, R. and He, J.Q., 2025. The association between triglyceride-glucose index and related parameters and risk of tuberculosis infection in American adults under different glucose metabolic states: a cross-sectional study. BMC Public Health, 25(1), pp.1-11.

Innovations in Detection, Equity, and Socioeconomic Support

1. Impact and Effectiveness of Active Case Finding (ACF) Strategies

• ACF efforts in Karachi led to a notable reduction in TB prevalence, especially among men, and improved sputum testing participation.
• Children's TB infection risk was significantly lower in ACF areas (ARTI: 0.6% vs. 1.1%), suggesting community-wide benefits.
• Despite detection, treatment linkage remained weak, with only 26% starting treatment.
• In Vietnam, the Double X (2X) strategy (CXR + Xpert) was highly effective in diverse settings, improving TB detection and treatment initiation.
• The 2X strategy was cost-efficient, integrated into national guidelines, and particularly effective among high-risk groups like older adults and smokers.

See also: Lin TB Lab

---

2. Diagnostic and Treatment Challenges

• Low treatment initiation despite diagnosis remains a critical issue (e.g., 57% of diagnosed cases in Karachi refused or were unreachable).
• Trace-positive Xpert Ultra results created diagnostic uncertainty.
• In the U.S., over half of TB patients require hospitalization, with treatment costs averaging $16,000–$23,000.
• Preventive care remains underused despite advances like IGRAs and rifamycin-based regimens.

See also: Benang Merah Research Center

---

3. Health Inequities and Disparities

• In the U.S., racial and ethnic disparities heavily influence TB incidence, case-fatality, and QALY loss—Black, Hispanic, and Native groups are disproportionately affected.
• Disparity-linked TB cases may reach 45% of total U.S. cases by 2035.
• Social determinants like income, delayed care, and insurance gaps are central to persistent disparities.
• A call to action urges Medicare coverage of TB screening to address systemic barriers for high-risk groups.

---

4. Socioeconomic Interventions for TB Control

• Conditional cash transfer (CCT) programs like Brazil's Bolsa Família were linked to significant reductions in TB incidence and mortality, especially in extremely poor and Indigenous populations.
• Even one-time cash incentives can drastically improve diagnostic process completion.
• Combining CCTs with counseling led to 82% treatment success vs. 66.9% in controls, reducing loss to follow-up.
• Socioeconomic stability (employment, food security) was closely tied to treatment success, reinforcing TB as both a medical and social issue.

---

5. Drug-Resistant TB and Genomic Surveillance

• A Thai study revealed a dominant, highly transmissible MDR-TB strain (L2.2.M3) accounting for 84.4% of cases.
• Whole-genome sequencing showed sustained transmission over time and space, confirming clonal expansion and urgent need for targeted containment.
• Genomic analysis enabled tracking of resistance evolution and highlighted pre-XDR and XDR clustering within dominant lineages.

References:

1. Khan, P.Y., Paracha, M.S., Grundy, C., Madhani, F., Saeed, S., Maniar, L., Dojki, M., Page-Shipp, L., Khursheed, N., Rabbani, W. and Riaz, N., 2024. Insights into tuberculosis burden in Karachi, Pakistan: A concurrent adult tuberculosis prevalence and child Mycobacterium tuberculosis infection survey. PLOS global public health, 4(8), p.e0002155.
2. Innes, A.L., Lebrun, V., Hoang, G.L., Martinez, A., Dinh, N., Nguyen, T.T.H., Huynh, T.P., Quach, V.L., Nguyen, T.B., Trieu, V.C. and Tran, N.D.B., 2024. An effective health system approach to end TB: implementing the double X strategy in Vietnam. Global Health: Science and Practice, 12(3).
3. Swartwood, N.A., Li, Y., Regan, M., Marks, S.M., Barham, T., Asay, G.R.B., Cohen, T., Hill, A.N., Horsburgh, C.R., Khan, A.D. and McCree, D.H., 2024. Estimated Health and Economic Outcomes of Racial and Ethnic Tuberculosis Disparities in US-Born Persons. JAMA Network Open, 7(9), pp.e2431988-e2431988.
4. Murrill, M.T., Salcedo, K., Tschampl, C.A., Ahamed, N., Coates, E.S., Flood, J., Wegener, D.H. and Shete, P.B., 2025. Policy Impediments to Tuberculosis Elimination: Consequences of an Absent Medicare National Coverage Determination for Tuberculosis Prevention. Journal of Immigrant and Minority Health, pp.1-6.
5. Thipkrua, N., Disrathakit, A., Chongsuvivatwong, V., Mahasirimongkol, S., Ruangchai, W., Palittapongarnpim, P., Chaiprasert, A., Pungrassami, P., Kamolwat, P., Suthum, K. and Tossapornpong, K., 2025. A large geno-spatial cluster of multi-drug resistant tuberculosis outbreak in a western district of Thailand. Infection, Genetics and Evolution, 128, p.105715.
6. Ismail, Nazir, Harry Moultrie, Judith Mwansa-Kambafwile, Andrew Copas, Alane Izu, Sizulu Moyo, Donald Skinner et al. "Effects of conditional cash transfers and pre-test and post-test tuberculosis counselling on patient outcomes and loss to follow-up across the continuum of care in South Africa: a randomised controlled trial." The Lancet Infectious Diseases (2025).
7. Shete, P.B., Kadota, J.L., Nanyunja, G., Namale, C., Nalugwa, T., Oyuku, D., Turyahabwe, S., Kiwanuka, N., Cattamanchi, A. and Katamba, A., 2023. Evaluating the impact of cash transfers on tuberculosis (ExaCT TB): a stepped wedge cluster randomised controlled trial. ERJ open research, 9(3).
8. Jesus, G.S., Gestal, P.F., Silva, A.F., Cavalcanti, D.M., Lua, I., Ichihara, M.Y., Barreto, M.L., Boccia, D., Sanchez, M.N. and Rasella, D., 2025. Effects of conditional cash transfers on tuberculosis incidence and mortality according to race, ethnicity and socioeconomic factors in the 100 Million Brazilian Cohort. Nature Medicine, pp.1-10.

Yoseph Leonardo Samodra

TBC 064