Infection prevention
developing countries. She added: “TB remains a global catastrophe because our efforts to control the spread are hindered by inadequate testing, which is slow and reliant on specialist equipment and labs. “A third of people who get infected go undiagnosed and remain infectious. In our study, we combined a new measurement technique with deep mathematical analysis to identify these six new markers of TB disease. “It could lead to a transformative alternative
to diagnosing the condition – a simple test that detects proteins in the bloodstream whose levels differ between people with TB, healthy individuals, and those suffering from other respiratory illnesses.” The University of Southampton study was undertaken with experts from the University of Cape Town in South Africa and Cayetano Heredia University in Lima, Peru, and was funded by the UK Medical Research Council and the National Institute for Health and Care Research (NIHR) Southampton Biomedical Research Centre. Academics leading the investigation studied
proteins found in the blood of people with active TB in Africa and South America. They compared the biomarkers to those found in healthy people and patients with lung infections, identifying 118 proteins that differed significantly between the groups. The experts then narrowed these down to the six proteins that, they said, can be used to distinguish contagious patients with TB from people in good health or with lung conditions. The findings are a roadmap to developing a TB
test that is as simple as the lateral flows used during COVID, said study co-director Dr. Diana Garay-Baquero, also from Southampton. She commented: “The new markers we
discovered are truly exciting, but the important work now is to develop these into tests that can be used for the millions of people who are transmitting TB without knowing it. As the COVID-19 pandemic confirmed, we ignore highly infectious airborne diseases at our peril.”
Preventative treatment In the US, there has also been some breakthrough research on who should be targeted for preventative treatment.5
clarity to this issue, finding that exposed individuals with confirmed TB infection, i.e. a positive skin or blood test, should receive priority treatment in settings with a low prevalence of the disease, regardless of their age. However, in high-burden settings, all exposed individuals should be considered for preventative treatment, even without a confirmed infection, according to the findings published in The Lancet Respiratory Medicine. “Tuberculosis affects tens of millions of
people every year and has long-term lasting effects, even after people recover,” says study lead and corresponding author Dr. Leonardo Martinez, assistant professor of epidemiology at BUSPH. “Finding ways to optimise prevention is really important to tackle the epidemic.” For the study, Dr. Martinez and colleagues
conducted a comprehensive review and analysis to identify new cases of TB among people who were in close contact with individuals diagnosed with the disease, and compared the effectiveness of preventive treatment in these exposed individuals based on age, infection status, and burden of TB in their settings. Among 439,644 participants, the team found
Preventive
treatment for TB can stop latent TB infections from developing into deadly TB disease. Despite TB infection being fully treatable, there is no global consensus as to which subgroups of individuals exposed to TB should be prioritised for preventive treatment, nor whether the benefits of this treatment vary based on factors such as age or confirmed infection. A new study led by a Boston University School of Public Health (BUSPH) researcher provides
that preventive TB treatment was 49% effective among the 2,496 individuals who developed TB, but particularly among individuals with a positive skin or blood test (for which the effectiveness was 80%). Notably, the researchers found that preventive TB treatment was not effective in most individuals who did not show evidence of infection, except for children under 5. For those who did have a positive skin or blood test, the effectiveness of the treatment was comparable among individuals of all age groups (adults, children ages 5-17, and children under 5) and the treatment was more effective among individuals in high-burden settings than low-burden settings.
The team also estimated the number of individuals needed to receive treatment (NNT) in order to prevent one person from developing TB disease. Regardless of infection status, the NNT was lower in high-burden settings (29 to 43 people) versus low-burden settings (213 to 455 people). Despite the fact that individuals with negative blood or skin tests do not seem to benefit from preventive treatments, the researchers say the overall low NNT may justify prioritising this treatment to all exposed contacts in areas where testing for TB infection is inaccessible. “While it is critical to find and treat people
who are spreading TB in the community, the threat of global TB will never end until people with latent TB receive treatment,” said study coauthor Dr. C. Robert Horsburgh, professor of global health. “The results of this study show just how effective such treatment can be.”
Post-infection: key findings While efforts are underway to end TB, post-TB lung disease is also an under-recognised global challenge. UK researchers6
found compelling
evidence that TB can have a lasting impact on the lungs of individuals who have been successfully treated for the disease. TB survivors have smaller lungs with narrower airways and slower air flow, the analysis of data on tens of thousands of individuals from around the world found. “This damage could have a profound effect
on long-term health, reduce quality of life and affect ability to work and carry out day-to- day tasks,” said lead researcher, Dr. Sharenja Ratnakumar, of St George’s, University of London. “With growing numbers of people being successfully treated for TB, the finding strongly indicates that post-TB lung disease is an under- recognised global challenge.”
March 2025 I
www.clinicalservicesjournal.com 47
t
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64
