Using host-responses and pathogen genomics to improve diagnostics for tuberculosis in the Philippines

结核病是菲律宾的一个重大公共卫生问题，仅2016年就有30多万例病例和2.2万例死亡。世界卫生组织估计，全世界每年有900万新的结核病病例，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6个多月的治疗，诊断无法帮助识别早期治疗失败。最终的耐药诊断可能意味着延长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。这种检测方法能够更早地识别患者并监测他们的治疗反应。这将允许更早的治疗和更快地改变治疗方案，以更合适的方案。这个项目将把热带医学研究所与伦敦卫生学院和热带医学学院——两个处于传染病研究前沿的机构——联系起来，使世界一流的研究成为可能。该项目还将允许在基因组技术和分析方面培训菲律宾的研究人员，从而使当地的能力建设成为可能。

Tuberculosis disease (TB) is a major public health issue in the Philippines with over 300,000 cases and 22,000 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 Research Institute for Tropical Medicine with the London School of Hygiene and Tropical Medicine - two institutions at the forefront of infectious disease research - to enable world class research. The project will also allow for the training of Philippine researchers in genomic technologies and analysis to allow local capacity building.