Establishment of TB-MBLA to Investigate Treatment Response of Drug Resistant TB Patients.
Establishment of TB-MBLA to investigate treatment response of drug resistant TB patients- Kibong’oto Infectious Diseases Hospital
Treatment of drug resistant tuberculosis including the rifampicin and or multidrug resistant tuberculosis (RR/MDR-TB) is more complex that not only it takes longer to complete the prescribed regimen but also requires use of at least 5 anti-TB medicines. Currently, monitoring of microbiological efficacy of these treatment regimens depend on detecting the acid-fast bacilli by using smear microscopy and culturing M. tuberculosis on solid or liquid culture system. However, smear microscopy is less sensitive that it does not detect AFB below 5000, and cannot distinguish M. tuberculosis, the causative agent for RR/MDR-TB, from non-tuberculous mycobacteria. Culture can address all limitations of smear microscopy, but it is laborious, delays results for up 8 weeks and yet it is prone to contamination for up 15%, which further limits clinical decisions. For the first time in 2021, St. Andrew’s University in Scotland, UK and Kibong’oto Infectious Diseases Hospital (KIDH) in Tanzania collaborates to build on-site capacity for TB molecular bacterial load assay (TB-MBLA), a potential tool for monitoring MDR-TB treatment response.
The overall aim of the project is to deploy TB-MBLA in patients with RR/MDR-TB using injectable free second line anti-TB regimen. A total of 66 patients receiving a bedaquiline-based second-line anti-TB regimen will be enrolled. Each patient will provide 20 serial sputa for detecting M. tuberculosis 16S rRNA by TB-MBLA. The M. tuberculosis will be cultured from sputum on solid and liquid MGIT 960 culture media. Non-linear mixed effects strategies will be used to model the M. tuberculosis killing rates. Findings from this project will guide the design of strategies for shortening and simplifying RR/MDR-TB treatment. TB-MBLA, a biomarker facilitates inclusion of the new or repurposed drugs into RR/MDR-TB regimen. Likewise, the project will build capacity to laboratorians and clinicians at KIDH on clinical applications of TB-MBLA for monitoring TB treatment response.
Stella Mpagama & Peter Mbelele
