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The (re)discovery of the spectrum of TB

R Houben(1)

1: London School of Hygiene and Tropical Medicine

Since the 1980s, TB has been thought and taught to either present as a ‘latent infection’ or ‘active disease’, which informed but also constrained global TB policy and research. After repeated failures of DOTS and other interventions to reduce the burden of TB, the past 15 years have seen a growing push against the classic TB paradigm. Informed by conceptual thinking and empirical evidence from the past and present, we now recognise that TB operates on a spectrum, including non-infectious and subclinical TB, with a wide variety of potential disease pathways.


In his presentation Prof Houben will give an overview of the past decade-plus of turmoil in TB, highlighting how most of this was widely known in the past, where we are now, and explore some of the future consequences of the spectrum for clinical care, research and policy. 

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