TB and HIV research

Despite declining tuberculosis (TB) cases and death rates, in 2010 there were still an estimated 8.8 million new cases of TB, of which 12-14% were people also infected with HIV. The proportion of TB cases co-infected with HIV is highest in the African region, which accounted for 82% of TB cases among people living with HIV. The five countries with the largest number of new TB cases were India, China, South Africa, Indonesia and Pakistan. China and India alone accounted for 38% of all TB cases globally, illustrating the enormous challenges borne by several low- and middle-income countries with insufficient resources and competing priorities. In the meantime, weak health systems and policies in these countries have been one of the key obstacles in achieving universal access to TB care. TDR has supported research in some of these low- and middle-income countries to identify efficient diagnosis and treatment options.

Specific objectives

  • Develop evidence to shorten and simplify the treatment of TB in HIV-infected and -uninfected TB patient populations
  • Develop evidence for timing and optimal management of HIV-infected TB patients
  • Develop evidence in support of scaling up access to TB diagnosis and treatment, particularly for the poor and marginalized populations;
  • Support research aimed at developing and utilizing positive synergies and interactions between TB control programmes and health systems strengthening to optimize service delivery in disease endemic countries

TB specimen bank

New diagnostic tests for TB suitable for low-income settings are urgently needed. Current methods of diagnosis (based on sputum smear microscopy) are both labour-intensive and insensitive.

An important obstacle to the development of new diagnostics tests for TB is the lack of access to reference materials. The TDR TB Specimen Bank was launched in June 2000 to address this need by providing an invaluable, growing resource of well-characterized clinical materials for use by academic and commercial test developers. It is now managed by the Foundation for Innovative New Diagnostics (FIND).

Samples are available of sputum, serum, saliva and urine collected in prospective studies, supported with full microbiologic examination and clinical follow-up. Materials are frozen on site, and maintained deep-frozen at a central distribution site. Each sample is linked to detailed clinical and microbiological information.

All requests for use of these materials will undergo a rapid process of review.

For additional information, contact Andy Ramsay, e-mail: ramsaya@who.int.

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