Chest X-ray AI alone beat AI plus CRP for community TB screening, and nirsevimab's second-season signal

The edition in brief

A paired-screening trial of 20,023 household members in Lesotho and South Africa compared computer-aided detection (CAD) on chest X-ray alone with CAD followed by point-of-care CRP. Of 73 TB cases found by either, CAD alone detected 94.5% and CAD plus CRP 82.2% (difference −12.3%), failing noninferiority, and the combined approach cost 37% more per case found. Published in July, it bears directly on active case-finding programmes such as India's. A Lancet Infectious Diseases commentary on the NIRSE-GAL study notes that universal infant nirsevimab was associated with 86% fewer RSV lower respiratory admissions in the first season and 55% fewer in the second, without signs of enhanced disease; the second-season finding is unreplicated. A Lancet Infectious Diseases review summarises real-world effectiveness of maternal RSV vaccine, infant monoclonals and older-adult vaccines, and notes that cost confines them mostly to richer settings. The FDA recorded a supplement to a generic voriconazole application, an administrative action. The pearl covers voriconazole level monitoring.