Using host-responses and pathogen genomics to improve diagnostics for tuberculosis in Bandung, Indonesia

结核病（TB）是印度尼西亚的一个主要公共卫生问题，仅2016年就有超过100万例病例和123，000例死亡。世界卫生组织估计，全球每年有900万新发结核病病例，近200万人死亡。多药耐药菌株的日益流行使疾病控制变得困难。直到今天，诊断活动性结核病，特别是在早期阶段，是困难的，需要痰样本。此外，目前的治疗需要超过6个月的治疗，诊断无法帮助识别早期治疗失败。最终诊断出耐药性可能意味着需要延长2年的进一步治疗。该项目旨在确定一种新的诊断方法，该方法使用少量血液样本来测量患者对结核病感染的反应，而不是直接寻找结核菌。这种检测能够更早地识别患者并监测他们的治疗反应。该项目将把帕贾贾兰大学医学院Hasan Sadikin博士医院与Eijkman分子生物学研究所和伦敦卫生和热带医学院这三个处于传染病研究前沿的机构联系起来，以实现世界级的研究。该项目还将允许对印度尼西亚研究人员进行基因组技术和分析方面的培训，以便进行当地能力建设。

Tuberculosis disease (TB) is a major public health issue in Indonesia with over one million cases and 123,000 deaths in 2016 alone. Worldwide, the World Health Organisation estimates that there are nine million new TB cases and nearly two million deaths each year. The increasing prevalence of multi-drug resistance strains is making disease control difficult. Until today, diagnosing active TB, especially in the early stages, is difficult and requires a sputum sample. In addition, current treatment takes more than 6 months of therapy, with diagnostics unable to help identify early treatment failure. An eventual diagnosis of drug resistance may mean extended further treatment for 2 years.This project seeks to identify a new diagnostic assay that uses a small blood sample to measure the patient's response to the tuberculosis infection, instead of looking for the tuberculosis bacterium directly. This assay could be able to identify patients earlier and monitor their treatment response. This would allow earlier treatment and more rapid ability to alter therapy to a more appropriate regimen.This project will link the Dr. Hasan Sadikin Hospital, Faculty of Medicine Universitas Padjadjaran (DHSH-UNPAD), with the Eijkman Institute for Molecular Biology and the London School of Hygiene and Tropical Medicine - three institutions at the forefront of infectious disease research - to enable world class research. The project will also allow for the training of Indonesian researchers in genomic technologies and analysis to allow local capacity building.