On the occasion of the 46th Union meeting in Cape Town, South Africa, EDCTP already published its support for a unified response to the global problem of TB and childhood TB. The clear and immediate challenge for research is to develop better paediatric formulations and better diagnostic tools. On the occasion of World TB Day 2016, Prof. Alimuddin Zumla (Division of Infection and Immunity, University College London) – and also a Vice-Chairperson of the EDCTP Scientific Advisory Committee – and Prof. Peter D.O. Davis (University of Liverpool, United Kingdom ) summarised the recent initiatives and roadmaps to achieve the end of the TB epidemic.
They warned that global TB control may seem in reach but that we are “in reality far from achieving these bold targets.” The fight against TB will be still long and hard: a coordinated effort and unity of purpose by all parties involved is “the only way forward to achieve our ambitious targets using existing tools … whilst we wait for research and innovation to discover new and effective tools to control and prevent TB.”
TB Diagnostics: LAM TB
EDCTP invested significantly in the development of TB treatment, prevention and diagnostics. Recently, the results of the LAM TB diagnostics study, part of the EDCTP-funded TB-NEAT project led by Prof. Keertan Dheda, Cape Town University, South Africa, were published in The Lancet . The study team assessed a urine-based, lateral flow, point-of-care, lipoarabinomannan assay (LAM) and the effect of a LAM-guided strategy for the initiation of anti-tuberculosis treatment on mortality.
A pragmatic, randomised, parallel-group, multicentre trial was conducted in ten hospitals in Africa—four in South Africa, two in Tanzania, two in Zambia, and two in Zimbabwe. Eligible patients were HIV-positive adults aged at least 18 years who presented at least one of the following symptoms of tuberculosis (fever, cough, night sweats, or self-reported weight loss) while the severity of their illness necessitated admission to a hospital. The study showed that bedside LAM-guided initiation of anti-tuberculosis treatment in HIV-positive hospital inpatients with suspected tuberculosis was associated with reduced 8-week mortality.
The authors conclude that implementation of LAM testing is likely to offer the greatest benefit in hospitals where diagnostic resources are most scarce and where patients present with severe illness, advanced immunosuppression, and an inability to self-expectorate sputum.