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Evaluation of the Xpert MTB Host Response assay for the triage of patients [TB0108]

A triage test with a minimum sensitivity of 90% and specificity of 70%, meeting predefined operational targets, could help reduce underdiagnosis and misdiagnosis of tuberculosis, decrease delays in starting treatment, and lower the cost and infrastructure demands of current gold-standard sputum-based tests in high-burden settings.  Sweeney and colleagues validated a three-gene host blood signature, utilizing blood mRNA to measure markers associated with the host inflammatory response, which can differentiate tuberculosis disease from other conditions. This signature has been developed into an automated, blood-based quantitative PCR test on the GeneXpert platform, generating a TB Score based on the cycle threshold of expressed genes. Early studies from stored samples and interim results from a multisite study suggest that this test may achieve the WHO's target product profile minimum accuracy threshold for a tuberculosis triage test. We aimed to prospectively evaluate the diagnostic...
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Adults with Mtb infection and pre-DM have increased levels of IGR [TB0102]

Immunopathy associated with diabetes or pre-diabetes is characterized, in part, by chronic inflammation driven by persistent hyperglycemia, resulting in several complications. Generally, data from clinical tuberculosis (TB) studies indicate that patients with diabetes demonstrate a robust TB antigen-specific immune response. However, diabetes is paradoxically associated with worse TB clinical outcomes, including delayed culture conversion, increased risk of mortality, and higher rates of TB relapse. Although diabetes is an established risk factor for TB disease, additional information to identify individuals with diabetes and latent TB infection (LTBI) at greatest risk of progression to TB disease is urgently needed. Previous studies among children, adolescents, and adults who converted from a negative to a positive LTBI test reported that increased quantitative QuantiFERON-TB Gold (QFT) interferon-gamma (IFN-γ) values were predictive of progression to TB disease. Participants who self...
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TB control and prospects for reducing TB incidence, prevalence, and deaths globally

The technology to control TB has long existed, but it remains underutilized. Initially, the term "DOTS" (Directly Observed Treatment, Short-course) referred specifically to directly observed treatment combined with short-course chemotherapy. However, DOTS has evolved into a broader public health strategy with five principal elements: Political commitment. Case detection by sputum smear microscopy, primarily among symptomatic, self-referring patients. Standard short-course chemotherapy with supportive patient management, including DOT. A reliable system for regular drug supply. A standard recording and reporting system, including the evaluation of treatment outcomes. The MDG framework for TB control includes two measures aimed at DOTS implementation (case detection and treatment success) and three impact measures (incidence, prevalence, and deaths) relevant to all TB control methods. This second set of measures not only promotes epidemiological evaluation beyond implementation...
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