Funding £150,000 of new research into tuberculosis
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.
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.
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.
The researchers are working in Mozambique, where the country faces the triple burden of TB, MDR-TB, and TB in adults with HIV.
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.
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.
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.
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.
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 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.
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.
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.
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.
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