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Novel techniques for the detection of Pediatric TB in Ethiopia

埃塞俄比亚儿童结核病检测新技术

基本信息

批准号：
8318849
负责人：
ANDREA JENAY RUFF
金额：
$ 41.42万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-09-30 至 2016-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8318849
关键词：
5 year old Acid Fast Bacillae Staining Method Adult Age Algorithms Applications Grants Bacillus (bacterium)Bronchi Child Childhood Clinical Collaborations Control Groups Detection Developing Countries Development Diagnosis Diagnostic Diagnostic Procedure Disease Drug resistance Ethiopia Feces Gastric Acid Gene Mutation Genes Genus Mycobacterium Gold Growth HIV HIV Infections In Vitro Infection Institutes Laboratories Location Mediating Methods Microscopic Morbidity - disease rate Mutation Mycobacterium tuberculosis Outcome Peru Pharmaceutical Preparations Population Predisposition Prevalence Provider Recovery Research Resistance Resources Rifampicin resistance Rifampin Risk Saline Sampling Sensitivity and Specificity Specimen Speed System Techniques Testing Training Tube Tuberculin Test Tuberculosis Work abstracting aged base cost improved innovation lymph nodes mortality novel tool tuberculosis treatment

项目摘要

DESCRIPTION (provided by applicant): NOVEL TECHNIQUES FOR THE DETECTION OF PEDIATRIC TB IN ETHIOPIA ABSTRACT Diagnosis of pediatric tuberculosis (TB) in resource-limited settings with high rates of HIV and TB is severely limited by methods that are slow, inefficient, and costly, which leads to increased morbidity and mortality. Our research team has made significant progress in the development of new TB diagnostic tools that demonstrate significant advantages over the gold standard diagnostics in adults. We propose to evaluate the potential of these new tools as well as others for the detection and direct susceptibility testing of Mycobacterium tuberculosis (Mtb) in children from 0-5 years of age. This project will be set in Ethiopia, where pediatric TB and HIV co- infection are major problems. We hypothesize that, compared to current standard techniques, the diagnosis of active TB in children and the recovery of Mtb isolates from these children can be done more quickly, efficiently, and cost-effectively using alternative clinical specimens in combination with more rapid diagnostic methods for both confirmation of TB and detection of drug resistance. If our hypothesis is correct, use of these methods will allow clinicians to institute rapid treatment directed specifically against the bacterial isolate from the infected child, improving the speed and outcome of anti-tuberculous therapy. To evaluate the potential utility of these techniques, we propose two studies. In the first study, we will evaluate the testing of various clinical specimens using innovative, inexpensive tests that may greatly facilitate the diagnosis of pediatric TB in developing countries with high rates of TB and HIV co-infection. The second study will include children with confirmed TB (identified in the first study) and healthy age-matched children. We will evaluate three immunologically-based techniques for their sensitivity and specificity in the diagnosis of TB disease. We believe the results in known TB cases can be extrapolated to assess the potential utility of these tests in the diagnosis of the large population of children with TB who are not able to have disease microbiologically confirmed. NARRATIVE Diagnosis of pediatric tuberculosis (TB), particularly among young children and those who are infected with HIV is severely limited by methods that are slow, inefficient, and costly. Our research team has developed new TB diagnostic tools and ways of collecting specimens and we are proposing to evaluate them in young children in Ethiopia where pediatric TB and HIV co infection are major problems. If these methods work well, they could allow clinicians to institute rapid treatment directed specifically against the child's particular infection, improving the speed and outcome of TB therapy.

描述（由申请人提供）：埃塞俄比亚儿童结核病检测的新技术摘要在资源有限的环境中，艾滋病毒和结核病的高发病率，儿童结核病（TB）的诊断受到方法的严重限制，这些方法缓慢，效率低下，成本高，导致发病率和死亡率增加。我们的研究团队在开发新的结核病诊断工具方面取得了重大进展，这些工具在成人诊断中表现出明显优于金标准诊断的优势。我们建议评估这些新工具以及其他用于0-5岁儿童结核分枝杆菌（Mtb）检测和直接药敏试验的潜力。该项目将在埃塞俄比亚开展，那里的儿童结核病和艾滋病病毒合并感染是主要问题.我们假设，与目前的标准技术相比，儿童活动性结核病的诊断和从这些儿童中回收结核分枝杆菌分离株可以更快，更有效，更经济地使用替代临床标本结合更快速的诊断方法来确认结核病和检测耐药性。如果我们的假设是正确的，使用这些方法将使临床医生能够建立专门针对感染儿童细菌分离株的快速治疗，提高抗结核治疗的速度和结果。为了评估这些技术的潜在效用，我们提出了两项研究。在第一项研究中，我们将使用创新的、廉价的检测方法评估各种临床标本的检测，这些检测方法可能极大地促进结核病和艾滋病毒合并感染率高的发展中国家儿童结核病的诊断。第二项研究将包括确诊结核病的儿童（在第一项研究中确定）和健康的年龄匹配的儿童。我们将评估三种基于免疫学的技术在结核病诊断中的敏感性和特异性。我们认为，已知结核病病例的结果可以外推，以评估这些检测在诊断大量无法获得微生物学证实的结核病儿童中的潜在效用。儿科结核病（TB）的诊断，特别是在幼儿和那些感染艾滋病毒的人中，受到缓慢，低效和昂贵的方法的严重限制。我们的研究团队开发了新的结核病诊断工具和标本采集方法，我们建议在埃塞俄比亚的幼儿中进行评估，因为儿童结核病和艾滋病毒合并感染是主要问题。如果这些方法效果良好，它们可以让临床医生针对儿童的特定感染进行快速治疗，提高结核病治疗的速度和效果。