{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T08:07:03Z","timestamp":1779350823470,"version":"3.51.4"},"reference-count":65,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":55,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Commun Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Globally, the burden of tuberculosis falls more on men than women and children, and there are large gaps between men and women at all stages of exposure, disease incidence, and treatment. We examined the impact of addressing determinants of these gender gaps in Kenya, Malawi, Nigeria, and Uganda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We created a deterministic transmission model of tuberculosis, calibrated to country-specific data on prevalence, incidence, mortality, and notifications between 2010 and 2022. We examined the potential epidemiological impact of strategies to increase treatment coverage among men and decrease the effects of social and structural determinants that increase men\u2019s risk of developing TB. We investigated\u00a0the impact\u00a0(overall and by age and sex) on projected incidence and mortality in 2035, and notification rates between 2025 and 2030.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our modelling estimates that increasing treatment coverage among men could reduce incidence in 2035 between 2.4% [95% uncertainty interval (UI)\u00a00.2-6.0%] in Malawi and 23.0% [UI 16.8-29.3%] in Nigeria. Reducing men\u2019s excess risk of tuberculosis could similarly reduce incidence in 2035 between 9.8% [UI 7.5-12.6%] in Malawi and 30.1% [UI 24.1-40.5%] in Kenya. Impacts extend across the population with median estimates of country-level declines in incidence of between 0.9-17.8% and 1.4-22.2% in women and children, respectively, across the four countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Strategies that prioritise increasing tuberculosis treatment coverage among men and mitigating men\u2019s higher susceptibility to tuberculosis could reduce disease burden for men, women, and children. Such gender-responsive strategies are essential to ensure a person-centred tuberculosis response and accelerate global progress towards the EndTB targets<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s43856-026-01536-3","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T17:04:49Z","timestamp":1774631089000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Modelling the impact of increasing tuberculosis treatment coverage and addressing determinants of risk in men"],"prefix":"10.1038","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9886-8104","authenticated-orcid":false,"given":"Alexandra S.","family":"Richards","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4072-9715","authenticated-orcid":false,"given":"Mphatso D.","family":"Phiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1189-5861","authenticated-orcid":false,"given":"Jasper","family":"Nidoi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremiah","family":"Chakaya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0329-9613","authenticated-orcid":false,"given":"Peter","family":"MacPherson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2023-2840","authenticated-orcid":false,"given":"Bruce J.","family":"Kirenga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John S.","family":"Bimba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chukwuebuka","family":"Ugwu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6040-7123","authenticated-orcid":false,"given":"Rhoda","family":"Pola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. Bertel","family":"Squire","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine C.","family":"Horton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"1536_CR1","unstructured":"World Health Organization. Global tuberculosis report, World Health Organization; 2024. Available: https:\/\/www.who.int\/teams\/global-tuberculosis-programme\/tb-reports\/global-tuberculosis-report-2024 (2024)."},{"key":"1536_CR2","doi-asserted-by":"publisher","first-page":"2431","DOI":"10.1093\/aje\/kwy131","volume":"187","author":"KC Horton","year":"2018","unstructured":"Horton, K. C., Sumner, T., Houben, R. M. G. J., Corbett, E. L. & White, R. G. A Bayesian approach to understanding gender differences in tuberculosis disease burden. Am. J. Epidemiol. 187, 2431\u20132438 (2018).","journal-title":"Am. J. Epidemiol."},{"key":"1536_CR3","doi-asserted-by":"crossref","unstructured":"Rickman, H. M. et al. Sex differences in the risk of Mycobacterium tuberculosis infection: a systematic review and meta-analysis of population-based immunoreactivity surveys. LPH. 10, e588\u201398 (2025).","DOI":"10.1016\/S2468-2667(25)00120-3"},{"key":"1536_CR4","doi-asserted-by":"publisher","first-page":"e1002119","DOI":"10.1371\/journal.pmed.1002119","volume":"13","author":"KC Horton","year":"2016","unstructured":"Horton, K. C., MacPherson, P., Houben, R. M. G. J., White, R. G. & Corbett, E. L. Sex differences in tuberculosis burden and notifications in low- and middle-income countries: A systematic review and meta-analysis. PLOS Med. 13, e1002119 (2016).","journal-title":"PLOS Med."},{"key":"1536_CR5","doi-asserted-by":"publisher","first-page":"26292","DOI":"10.3402\/gha.v8.26292","volume":"8","author":"J Chikovore","year":"2015","unstructured":"Chikovore, J., Hart, G., Kumwenda, M., Chipungu, G. A. & Corbett, L. For a mere cough, men must just chew conjex, gain strength, and continue working\u2019: The provider construction and tuberculosis care-seeking implications in Blantyre, Malawi. Glob. Health Action 8, 26292 (2015).","journal-title":"Glob. Health Action"},{"key":"1536_CR6","unstructured":"World Health Organization Global Tuberculosis Programme. WHO TB profiles. https:\/\/worldhealthorg.shinyapps.io\/tb_profiles\/ (2024)."},{"key":"1536_CR7","unstructured":"World Health Organization. National tuberculosis prevalence surveys 2007-2016. Available: https:\/\/iris.who.int\/handle\/10665\/341072."},{"key":"1536_CR8","doi-asserted-by":"publisher","first-page":"640","DOI":"10.1016\/j.it.2022.06.004","volume":"43","author":"M Gupta","year":"2022","unstructured":"Gupta, M., Srikrishna, G., Klein, S. & Bishai, W. R. Genetic and hormonal mechanisms underlying sex-specific immune responses in tuberculosis. Trends Immunol. 43, 640\u2013656 (2022).","journal-title":"Trends Immunol."},{"key":"1536_CR9","first-page":"6","volume":"24","author":"J Wessels","year":"2019","unstructured":"Wessels, J., Walsh, C. M. & Nel, M. Smoking habits and alcohol use of patients with tuberculosis at Standerton Tuberculosis Specialised Hospital, Mpumalanga, South Africa. Health SA 24, 6 (2019).","journal-title":"Health SA"},{"key":"1536_CR10","doi-asserted-by":"publisher","unstructured":"Davies L. R. L., et al. IFN-\u03b3 independent markers of Mycobacterium tuberculosis exposure among male South African gold miners. eBioMedicine. 93. https:\/\/doi.org\/10.1016\/j.ebiom.2023.104678 (2023).","DOI":"10.1016\/j.ebiom.2023.104678"},{"key":"1536_CR11","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-77504-1","volume":"10","author":"VG Sequera","year":"2020","unstructured":"Sequera, V. G. et al. Increased incarceration rates drive growing tuberculosis burden in prisons and jeopardize overall tuberculosis control in Paraguay. Sci. Rep. 10, 21247 (2020).","journal-title":"Sci. Rep."},{"key":"1536_CR12","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-021-11136-6","volume":"21","author":"Kleynhans","year":"2021","unstructured":"Kleynhans et al. A cross-sectional study measuring contact patterns using diaries in an urban and a rural community in South Africa, 2018. BMC Public Health 21, 1055 (2021).","journal-title":"BMC Public Health"},{"key":"1536_CR13","doi-asserted-by":"publisher","DOI":"10.1016\/j.epidem.2022.100590","volume":"40","author":"D Thindwa","year":"2022","unstructured":"Thindwa, D. et al. Social mixing patterns relevant to infectious diseases spread by close contact in urban Blantyre, Malawi. Epidemics 40, 100590 (2022).","journal-title":"Epidemics"},{"key":"1536_CR14","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-00799-1","volume":"11","author":"E Del Fava","year":"2021","unstructured":"Del Fava, E. et al. Individual\u2019s daily behaviour and intergenerational mixing in different social contexts of Kenya | Scientific Reports. Sci. Rep. 11, 21589 (2021).","journal-title":"Sci. Rep."},{"key":"1536_CR15","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-021-06475-z","volume":"21","author":"PB Miller","year":"2021","unstructured":"Miller, P. B. et al. Association between tuberculosis in men and social network structure in Kampala, Uganda. BMC Infect. Dis. 21, 1023 (2021).","journal-title":"BMC Infect. Dis."},{"key":"1536_CR16","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-016-0608-4","volume":"14","author":"RMGJ Houben","year":"2016","unstructured":"Houben, R. M. G. J. et al. TIME impact a new user-friendly tuberculosis (TB) model to inform TB policy decisions. BMC Med. 14, 56 (2016).","journal-title":"BMC Med."},{"key":"1536_CR17","doi-asserted-by":"publisher","first-page":"e0000784","DOI":"10.1371\/journal.pgph.0000784","volume":"2","author":"KC Horton","year":"2022","unstructured":"Horton, K. C. et al. Population benefits of addressing programmatic and social determinants of gender disparities in tuberculosis in Vietnam: A modelling study. PLOS Glob. Public Health 2, e0000784 (2022).","journal-title":"PLOS Glob. Public Health"},{"key":"1536_CR18","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1016\/S2213-2600(24)00028-6","volume":"12","author":"AK Coussens","year":"2024","unstructured":"Coussens, A. K. et al. Classification of early tuberculosis states to guide research for improved care and prevention: An international delphi consensus exercise.  Lancet Respir. Med. 12, 484\u2013498 (2024).","journal-title":"Lancet Respir. Med."},{"key":"1536_CR19","doi-asserted-by":"publisher","first-page":"i7","DOI":"10.1093\/ije\/dyq016","volume":"39","author":"J Stover","year":"2010","unstructured":"Stover, J., McKinnon, R. & Winfrey, B. Spectrum: A model platform for linking maternal and child survival interventions with AIDS, family planning and demographic projections. Int. J. Epidemiol. 39, i7\u2013i10 (2010).","journal-title":"Int. J. Epidemiol."},{"key":"1536_CR20","unstructured":"UN World Population Prospects. Population by select age groups - female. https:\/\/population.un.org\/wpp\/Download\/Standard\/Population\/ (2024)."},{"key":"1536_CR21","unstructured":"UN World Population Prospects. Population by select age groups - male. https:\/\/population.un.org\/wpp\/Download\/Standard\/Population\/ (2024)."},{"key":"1536_CR22","unstructured":"World Health Organization Global Tuberculosis Programme. WHO TB burden estimates. https:\/\/www.who.int\/teams\/global-tuberculosis-programme\/data (2024)."},{"key":"1536_CR23","unstructured":"World Health Organization. Bacillus calmette-gu\u00e9rin (BCG) vaccination coverage. https:\/\/immunizationdata.who.int\/pages\/coverage\/BCG.html?CODE=Global+KEN+NGA+UGA+MWI&YEAR= (2024)."},{"key":"1536_CR24","unstructured":"World Health Organization Global Tuberculosis Programme. Treatment success rate: HIV-positive TB cases. https:\/\/www.who.int\/data\/gho\/data\/indicators\/indicator-details\/GHO\/treatment-success-rate-hiv-positive-tb-cases (2023)."},{"key":"1536_CR25","unstructured":"World Health Organization Global Tuberculosis Programme. TB: Treatment success. https:\/\/www.who.int\/data\/gho\/data\/themes\/topics\/indicator-groups\/indicator-group-details\/GHO\/tb-treatment-success (2024)."},{"key":"1536_CR26","doi-asserted-by":"publisher","first-page":"e684","DOI":"10.1016\/S2214-109X(23)00082-7","volume":"11","author":"AS Richards","year":"2023","unstructured":"Richards, A. S. et al. Quantifying progression and regression across the spectrum of pulmonary tuberculosis: A data synthesis study.  Lancet Glob. Health 11, e684\u2013e692 (2023).","journal-title":"Lancet Glob. Health"},{"key":"1536_CR27","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2221186120","volume":"120","author":"KC Horton","year":"2023","unstructured":"Horton, K. C., Richards, A. S., Emery, J. C., Esmail, H. & Houben, R. M. G. J. Reevaluating progression and pathways following Mycobacterium tuberculosis infection within the spectrum of tuberculosis. Proc. Natl. Acad. Sci. 120, e2221186120 (2023).","journal-title":"Proc. Natl. Acad. Sci."},{"key":"1536_CR28","doi-asserted-by":"publisher","first-page":"e88","DOI":"10.1093\/cid\/ciaa602","volume":"73","author":"R Ragonnet","year":"2021","unstructured":"Ragonnet, R. et al. Revisiting the natural history of pulmonary tuberculosis: A Bayesian estimation of natural recovery and mortality rates. Clin. Infect. Dis. 73, e88\u2013e96 (2021).","journal-title":"Clin. Infect. Dis."},{"key":"1536_CR29","doi-asserted-by":"publisher","DOI":"10.7554\/eLife.82469","volume":"12","author":"JC Emery","year":"2023","unstructured":"Emery, J. C. et al. Estimating the contribution of subclinical tuberculosis disease to transmission: An individual patient data analysis from prevalence surveys. eLife 12, e82469 (2023).","journal-title":"eLife"},{"key":"1536_CR30","doi-asserted-by":"publisher","first-page":"1308","DOI":"10.1111\/tmi.13485","volume":"25","author":"I Law","year":"2020","unstructured":"Law, I. & Floyd, K. Group the ATPS. National tuberculosis prevalence surveys in africa, 20082016: An overview of results and lessons learned. Trop. Med. Int. Health 25, 1308\u20131327 (2020).","journal-title":"Trop. Med. Int. Health"},{"key":"1536_CR31","unstructured":"World Health Organization Global Tuberculosis Programme. WHO TB incidence estimates disaggregated by age group, sex, and risk factor. https:\/\/www.who.int\/teams\/global-tuberculosis-programme\/data (2024)."},{"key":"1536_CR32","unstructured":"World Health Organization Global Tuberculosis Programme. Case notifications. https:\/\/www.who.int\/teams\/global-tuberculosis-programme\/data (2024)."},{"key":"1536_CR33","unstructured":"National Tuberculosis Leprosy and Lung Disease Program, Republic of Kenya Ministry of Health. Kenya tuberculosis prevalence survey 2016. Nairobi, Kenya; Available: https:\/\/www.nltp.co.ke\/survey-reports-2\/ (2018)."},{"key":"1536_CR34","unstructured":"Ministry of Health National TB Control Programme. Technical report: Malawi tuberculosis prevalence survey (2013\u20132014) (2016)."},{"key":"1536_CR35","unstructured":"Department of Public Health, Federal Republic of Nigeria. Report of the first national TB prevalence survey 2012, Nigeria. (2014)."},{"key":"1536_CR36","unstructured":"Ministry of Health Uganda and Makerere University School of Public Health. Population-based survey of prevalence of tuberculosis disease in Uganda 2014\u201315 (report). Makerere University School of Public Health; 2016. Available: https:\/\/library.health.go.ug\/index.php\/communicable-disease\/tuberculosis\/uganda-national-tuberculosis-prevalence-survey-2014-2015-survey."},{"key":"1536_CR37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v109.i10","volume":"109","author":"A Iskauskas","year":"2024","unstructured":"Iskauskas, A. et al. Emulation and history matching using the hmer package. J. Stat. Softw. 109, 1\u201348 (2024).","journal-title":"J. Stat. Softw."},{"key":"1536_CR38","unstructured":"RStudio Team. RStudio: Integrated development environment for R. Boston, MA: RStudio, PBC. Available: http:\/\/www.rstudio.com\/ (2020)."},{"key":"1536_CR39","unstructured":"R Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; Available: https:\/\/www.R-project.org\/ (2024)."},{"key":"1536_CR40","doi-asserted-by":"publisher","first-page":"400","DOI":"10.2471\/BLT.23.290641","volume":"102","author":"S Turyahabwe","year":"2024","unstructured":"Turyahabwe, S. et al. Community tuberculosis screening, testing and care, Uganda. Bull. World Health Organ. 102, 400\u2013409 (2024).","journal-title":"Bull. World Health Organ."},{"key":"1536_CR41","doi-asserted-by":"publisher","first-page":"136","DOI":"10.5588\/pha.23.0039","volume":"13","author":"C Ogoamaka","year":"2023","unstructured":"Ogoamaka, C. et al. The TB surge intervention: An optimized approach to TB case-finding in Nigeria. Public Health Action 13, 136\u2013141 (2023).","journal-title":"Public Health Action"},{"key":"1536_CR42","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/heapol\/czae087","volume":"40","author":"J Nidoi","year":"2025","unstructured":"Nidoi, J. et al. Finding the missing men with tuberculosis: A participatory approach to identify priority interventions in Uganda. Health Policy Plan. 40, 1\u201312 (2025).","journal-title":"Health Policy Plan."},{"key":"1536_CR43","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-025-12241-7","volume":"25","author":"C Ugwu","year":"2025","unstructured":"Ugwu, C. et al. Co-creation of a gender responsive TB intervention in Nigeria: A researcher-led collaborative study. BMC Health Serv. Res. 25, 63 (2025).","journal-title":"BMC Health Serv. Res."},{"key":"1536_CR44","unstructured":"Mwirigi N., Wandia R., Oira D., Kathure I., Nyaboga L. M. Breaking barriers: Targeting TB in the workplace for men. 55th union world conference on lung health, bali, 2024. pp. S583\u2013S584. (2024)."},{"key":"1536_CR45","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3786-2","volume":"18","author":"E Karamagi","year":"2018","unstructured":"Karamagi, E. et al. Improving TB case notification in northern Uganda: Evidence of a quality improvement-guided active case finding intervention. BMC Health Serv. Res. 18, 954 (2018).","journal-title":"BMC Health Serv. Res."},{"key":"1536_CR46","unstructured":"UN Women Africa. Women breaking barriers in the fish farming industry in Uganda. Available: https:\/\/africa.unwomen.org\/en\/stories\/feature-story\/2023\/08\/women-breaking-barriers-in-the-fish-farming-industry-in-uganda (2023)."},{"key":"1536_CR47","unstructured":"World Prison Brief. Uganda | world prison brief. Available: https:\/\/www.prisonstudies.org\/country\/uganda (2024)."},{"key":"1536_CR48","doi-asserted-by":"publisher","first-page":"e0224749","DOI":"10.1371\/journal.pone.0224749","volume":"14","author":"J Dowden","year":"2019","unstructured":"Dowden, J. et al. The impact of \u201cmale clinics\u201d on health-seeking behaviors of adult men in rural Kenya. PLOS ONE 14, e0224749 (2019).","journal-title":"PLOS ONE"},{"key":"1536_CR49","doi-asserted-by":"publisher","first-page":"e044944","DOI":"10.1136\/bmjopen-2020-044944","volume":"11","author":"MM Phiri","year":"2021","unstructured":"Phiri, M. M. et al. Improving pathways to care through interventions cocreated with communities: A qualitative investigation of men\u2019s barriers to tuberculosis care-seeking in an informal settlement in Blantyre, Malawi. BMJ Open 11, e044944 (2021).","journal-title":"BMJ Open"},{"key":"1536_CR50","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-023-15213-w","volume":"23","author":"FA K\u00f6ltringer","year":"2023","unstructured":"K\u00f6ltringer, F. A., Annerstedt, K. S., Boccia, D., Carter, D. J. & Rudgard, W. E. The social determinants of national tuberculosis incidence rates in 116 countries: A longitudinal ecological study between 20052015. BMC Public Health 23, 337 (2023).","journal-title":"BMC Public Health"},{"key":"1536_CR51","doi-asserted-by":"publisher","first-page":"1194","DOI":"10.1016\/S0140-6736(23)00013-2","volume":"401","author":"AB Gilmore","year":"2023","unstructured":"Gilmore, A. B. et al. Defining and conceptualising the commercial determinants of health.  Lancet 401, 1194\u20131213 (2023).","journal-title":"Lancet"},{"key":"1536_CR52","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2020.113639","volume":"270","author":"J Daniels","year":"2021","unstructured":"Daniels, J. et al. Masculinity, resources, and retention in care: South African men\u2019s behaviors and experiences while engaged in TB care and treatment. Soc. Sci. Med. 270, 113639 (2021).","journal-title":"Soc. Sci. Med."},{"key":"1536_CR53","doi-asserted-by":"crossref","unstructured":"Moyo S., Oladimeji O., Chikovore J., Zungu N. Tuberculosis and the Relevance of Sex- and Gender-Based Analysis. In: Gahagan J., Bryson M. K., editors. Cham: Springer International Publishing. pp. 85\u201397. (2021).","DOI":"10.1007\/978-3-030-71929-6_7"},{"key":"1536_CR54","doi-asserted-by":"publisher","unstructured":"Chikovore J. et al. Missing men with tuberculosis: the need to address structural influences and implement targeted and multidimensional interventions. BMJ Global Health. 2020;5. https:\/\/doi.org\/10.1136\/bmjgh-2019-002255.","DOI":"10.1136\/bmjgh-2019-002255"},{"key":"1536_CR55","unstructured":"Stop TB Partnership. Gender and TB: A stop TB partnership paper. Available: https:\/\/www.stoptb.org\/sites\/default\/files\/imported\/document\/TB-REACH_Gender2021-web.pdf."},{"key":"1536_CR56","doi-asserted-by":"publisher","first-page":"394","DOI":"10.4103\/ijmy.ijmy_191_24","volume":"13","author":"DC Oshi","year":"2024","unstructured":"Oshi, D. C. et al. Enhancing Knowledge and Beliefs: The Impact of a Gender-transformative Training Program on Tuberculosis Care in Southern Nigeria.  Int. J. Mycobacteriol. 13, 394\u2013403 (2024).","journal-title":"Int. J. Mycobacteriol."},{"key":"1536_CR57","doi-asserted-by":"crossref","unstructured":"George A. S., Amde W., Bello K., Jacobs T., Ravindran S. T. K. Shaping the African research agenda for gender transformative approaches to sexual and reproductive health and rights: A scoping review taking stock to re-align and move forward. Afr. J. Reprod. Health 29. Available: https:\/\/www.ajrh.info\/index.php\/ajrh\/article\/view\/5693.","DOI":"10.29063\/ajrh2025\/v29i6s.8"},{"key":"1536_CR58","doi-asserted-by":"publisher","first-page":"e1004452","DOI":"10.1371\/journal.pmed.1004452","volume":"21","author":"CJ Calderwood","year":"2024","unstructured":"Calderwood, C. J. et al. HIV, malnutrition, and noncommunicable disease epidemics among tuberculosis-affected households in east and southern Africa: A cross-sectional analysis of the ERASE-TB cohort. PLOS Med. 21, e1004452 (2024).","journal-title":"PLOS Med."},{"key":"1536_CR59","doi-asserted-by":"publisher","first-page":"e967","DOI":"10.1016\/S2214-109X(21)00176-5","volume":"9","author":"EB Wong","year":"2021","unstructured":"Wong, E. B. et al. Convergence of infectious and non-communicable disease epidemics in rural South Africa: A cross-sectional, population-based multimorbidity study.  Lancet Glob. Health 9, e967\u2013e976 (2021).","journal-title":"Lancet Glob. Health"},{"key":"1536_CR60","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1234785","volume":"14","author":"D Falzon","year":"2023","unstructured":"Falzon, D., Zignol, M., Bastard, M., Floyd, K. & Kasaeva, T. The impact of the COVID-19 pandemic on the global tuberculosis epidemic. Front. Immunol. 14, 1234785 (2023).","journal-title":"Front. Immunol."},{"key":"1536_CR61","unstructured":"Kenya Ministry of Health, National Tuberculosis, Leprosy and Lung Disease Programme. Kenya national strategic plan for 2023\/24 to 2027\/28. Available: https:\/\/nltp.co.ke\/national-strategic-plan-2019-2023-3\/."},{"key":"1536_CR62","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-10488-2","volume":"12","author":"JP Smith","year":"2022","unstructured":"Smith, J. P. et al. Characterizing tuberculosis transmission dynamics in high-burden urban and rural settings. Sci. Rep. 12, 6780 (2022).","journal-title":"Sci. Rep."},{"key":"1536_CR63","doi-asserted-by":"publisher","unstructured":"LIGHT modelling code. Zenodo. https:\/\/doi.org\/10.5281\/zenodo.18755975.","DOI":"10.5281\/zenodo.18755975"},{"key":"1536_CR64","doi-asserted-by":"crossref","unstructured":"Wickham H. ggplot2: Elegant graphics for data analysis. Springer-Verlag New York; Available: https:\/\/ggplot2.tidyverse.org (2016).","DOI":"10.1007\/978-3-319-24277-4_9"},{"key":"1536_CR65","doi-asserted-by":"publisher","first-page":"1686","DOI":"10.21105\/joss.01686","volume":"4","author":"H Wickham","year":"2019","unstructured":"Wickham, H. et al. Welcome to the tidyverse. J. Open Source Softw. 4, 1686 (2019).","journal-title":"J. Open Source Softw."}],"container-title":["Communications Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s43856-026-01536-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s43856-026-01536-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s43856-026-01536-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T07:21:10Z","timestamp":1779348070000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s43856-026-01536-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,27]]},"references-count":65,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1536"],"URL":"https:\/\/doi.org\/10.1038\/s43856-026-01536-3","relation":{},"ISSN":["2730-664X"],"issn-type":[{"value":"2730-664X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,27]]},"assertion":[{"value":"7 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"293"}}