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Funding £150,000 of new research into tuberculosis

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Around one quarter of the world’s population is infected with tuberculosis (TB) and it is the second-leading infectious killer after COVID-19. We’re funding five new collaborative research projects to tackle TB, led by researchers across Africa and the UK.

TB is an infectious disease caused by a bacterium which is spread in the air when an infected person sneezes, coughs, or spits. According to the World Health Organization (WHO), 1.6 million people died from TB in 2021.

Tuberculosis lungs

We’ve been able to make these research awards thanks to our Dorothy Temple Cross International TB Collaboration Scheme. This scheme aims to support Fellows taking on international, mutually beneficial research collaborations on TB between Africa and the UK.

Our five newly-awarded research projects are exploring multi-drug resistant TB, lung function in children and TB immunity, with the aim of increasing current understanding of the disease and how best to treat it.

1.6 million people

died from TB in 2021

Studying multi-drug resistant TB

Some forms of TB have evolved to survive and resist antibiotic drugs – they are referred to as multidrug-resistant TB (MDR-TB). This is an increasing global public health crisis - MDR-TB is the leading cause of death from antimicrobial resistance (AMR) globally.

Video-observed therapy for MDR-TB:

Dr Celso Khosa and Dr Tom Wingfield from Instituto Nacional de Saúde, Mozambique and the Liverpool School of Tropical Medicine, UK are exploring whether video-observed therapy could be a feasible intervention to help treat people with MDR-TB.

This therapy uses a smartphone (or other video-compatible equipment) to observe TB patients taking their medications remotely. This could help to ensure that people with TB who are not able to easily get to hospital settings complete their treatment successfully.

Dr Celso Khosa and Dr Tom Wingfield

The researchers are working in Mozambique, where the country faces the triple burden of TB, MDR-TB, and TB in adults with HIV.

Whole-genome sequencing in eastern DRC:

Dr Esto Bahizire and Dr Naomi Walker from the Catholic University of Bukavu, Democratic Republic of the Congo (DRC) and the Liverpool School of Tropical Medicine, UK are looking into MDR-TB in eastern DRC, where there is a high burden of the infection.

Dr Esto Bahizire and Dr Naomi Walker

Through studying mycobacterial culture and whole-genome sequencing in patients with pulmonary TB, they aim to unravel the genetics of MDR-TB and associate these with patient outcomes.

Face masks to test MDR-TB infectiousness:

Professor Veronica Ueckermann and Dr Caroline Williams from the University of Pretoria, South Africa and the University of Leicester, UK are investigating the period in which people with MDR-TB are infectious to others.

The bacteria which cause TB are spread from person to person in exhaled breath. This project uses a new way of capturing the exhaled bacteria, using face masks worn by people with MDR-TB, to understand when they are infectious to others.

Professor Veronica Ueckermann and Dr Caroline Willia

Currently, assessing infectiousness of MDR-TB patients is complex, often requiring multiple invasive tests and extended hospital stays. A simpler, less resource-intensive way of measuring infectiousness is needed, especially in low-income settings.

Measuring children's lung function

Children aged 15 years and below account for a tenth of all new TB cases, with the lungs being affected more than four out of five times. Many TB survivors develop changes in their lungs during the disease, and the effect may last beyond the end of treatment.

Making lung condition tests more diverse:

Spirometry can be used to assess lung function by using a device called a spirometer to measure how much air you can breathe out in one breath.

However, methods to assess lung function, like spirometry, are measured against reference ranges from research studies that have not captured diverse African populations, and there are none from West Africa.

Dr Esin Nkereuwem and Dr Toyn Togun

Dr Esin Nkereuwem and Dr Toyin Togun from MRC Unit The Gambia at the London School of Hygiene and Tropical Medicine, The Gambia are aiming to generate ethnically-appropriate reference values for spirometry in healthy Gambian children and adolescents. The intention is that these values will be used to better assess post-TB lung condition in children across West Africa.

TB Immunity

How to induce protective responses in the lungs:

Dr Mina Mehanny and Dr John E. Pearl from Ain Shams University, Egypt and the University of Leicester, UK are measuring the impact of lung exposure to a bacterial protein on anti-tuberculosis immunity.

Dr Mina Mehanny and Dr John E. Pearl

By testing how the amount and duration of protein exposure affects the function of anti-tuberculosis immune cells, the team hope to better understand how to induce protective responses in the lungs. This could support the development of new vaccines for TB.

The potential

Even with a vaccine and drugs to treat TB, the disease continues to devastate lives and families. This research has the potential to vastly improve current understanding of TB, how it is evolving to resist drug treatments, and how to better treat it.

In 2020, we funded five other collaborative TB projects, which you can read about here.

Researcher looking up
Despite over 90 years passing since Dorothy Temple Cross died from TB and her mother set up a Fund in her memory, the need for ongoing research in TB remains. TB is a global health threat – it occurs all over the world and is particularly prevalent in low- and middle- income countries. For this reason, it is vital that scientists and researchers are able to come together and collaborate internationally to battle this deadly, infectious disease. Dr Angela Hind, our Chief Executive