Tuberculosis

Tuberculosis
Tuberculosis is a disease of increasing importance. Patients spread the disease by coughing which produces aerosols containing the M. tuberculosis bacteria. Persons that have close contact with these patients may inhale these micro droplets and thus become infected. The mycobacteria multiply in the lung and cause disease in around 10% of the infected people. For HIV positive persons the risk of developing active TB, if they are infected, is much greater. Annually over three million people die from TB and up to one third of the world population is infected with Mycobacterium tuberculosis. Mortality is highest in the tropics, where over three-quarters of cases occur. 
It is estimated that the incidence of tuberculosis worldwide and the number of cases attributable to co-existing human immune-deficiency virus (HIV) infection will increase substantially during the next decade. Most of this burden occurs among the low-income countries of the world, particularly those in South East Asia and sub-Saharan Africa.

Diagnosis
Microscopic examination of sputum allows the mycobacteria to be observed and is an important marker for infectiousness. When done properly, approximately 60-70% of all adults with pulmonary tuberculosis can be identified by microscopy.  In practice however this proportion is around 40-60% at best. In the short tem improvements in microscopy are valuable but the real challenge is to develop a simple and cheap test- with at least as good detection limit as direct microscopy; 104 bacteria/ml- that can reduce the workload of the laboratory personnel.

 

Approach

KIT Biomedical Research performs research activities in the field of tuberculosis with the aim to improve existing tools and develop and implement tools for rapid and easy diagnosis of tuberculosis in developing countries. We aim at antigen or RNA/DNA detection assays and at new approaches such as electronic noses and other biosensors.

Ideally such tests should be rapid with a good sensitivity and specificity, with little sample treatment and low running costs. We collaborate with other knowledge institutes and companies in the Netherlands and abroad. We implement existing tests: microscopy, culture, nucleic acid amplification reactions as well as the newly developed tests in TB endemic countries in collaboration with institutes in developing countries.   KIT Biomedical Research also serves as a knowledge center and gives advice to researchers, policy makers and health workers from all over the world.

 

Focal points

  • Development of diagnostic tools for tuberculosis
  • Evaluation and application of diagnostic tools for tuberculosis in developing countries
  • Planning and introduction of TB diagnostic facilities
  • Quality control  of the TB laboratories
  • Advice to researchers, policy makers and health workers

Example

Characterisation of volatile components from tuberculosis cultures and tuberculosis patents breath


Current methods for tuberculosis diagnosis are unsatisfactory as they rely heavily on microscopy which is complex to perform and not sensitive enough. The potential to detect specific volatile compounds in the breath of infected persons is very appealing as little or no sample treatment would be required and a chemical detection could in theory be rapid sensitive and specific. In order to realize this goal we are currently undertaking a detailed study of the volatiles produced by M. tuberculosis and assessing their suitability as diagnostic biomarkers.

The specific objectives of the study are:

  • To characterize the volatile compounds produced by M. tuberculosis and identify compounds that may be useful for diagnosing infection with M. tuberculosis
  • To specify (hardware and software) needed for field studies to demonstrate the feasibility of this approach

To select field sites and perform a stepwise evaluation in two endemic countries

Projects


Publications


Team members


Contact

For further information please contact Dr. Arend Kolk or Dr. Richard Anthony

Tags

disease control | diagnostics | infectious diseases | tuberculosis |

Royal Tropical Institute