Six Groundbreaking Studies on TB Presented at the Union World Conference on Lung Health
At the recent Union World Conference on Lung Health in Copenhagen, Denmark, numerous studies and innovations were presented that could significantly impact the fight against tuberculosis (TB). Spotlight highlights six of the most notable findings.
1. Dispensing All TB Prevention Pills at Once Improves Treatment Completion
One of the key challenges in TB prevention is ensuring that individuals who have been exposed to the bacteria complete their treatment. A study called ThiPhiSA explored whether dispensing all pills for a three-month course of TB preventive therapy (TPT) at once would lead to better adherence compared to collecting them at regular intervals.
The study involved 268 households in KwaZulu-Natal, South Africa. Participants were randomly assigned to one of two groups: one receiving a two-week supply of the standard 3HP regimen (isoniazid and rifapentine taken weekly for three months), and the other receiving the full three-month course at once. The results showed that 86% of those who received all the pills upfront completed their treatment, compared to just 28% in the group that had to collect pills regularly.
This approach was found to be safe, with no serious adverse events reported. Dr. Adrienne Shapiro, from the University of Washington, emphasized that multi-month delivery of TPT is both safe and convenient, and should be adopted to improve TB prevention coverage.
2. New Medicine Could Shorten TB Treatment Duration
Researchers are working to reduce the duration of TB treatment, which typically lasts six months. A phase 2 trial of an experimental drug called sorfequiline, used in combination with pretomanid and linezolid, showed promising results.
The regimen, known as SpaL, was tested on 309 participants with newly diagnosed TB. Those who received 100mg of sorfequiline along with the other two drugs had a 64% chance of stopping treatment after 15 weeks, compared to lower percentages in the other arms. The study also found that the 100mg arm showed better stable sputum culture conversion than the current standard regimen.
Dr. Morounfolu Olugbosi, the medical lead for the study, noted that the regimen was well tolerated, with no significant safety concerns. While this trial focused on drug-susceptible TB, future studies will explore its effectiveness for drug-resistant cases.
3. Co-morbidities Significantly Impact TB Mortality
A prospective cohort study in South Africa revealed that co-morbidities play a critical role in TB mortality. Among 2,000 adults with pulmonary TB, 14.3% died within 15 months. The study identified five key co-morbidities—HIV, smoking, undernutrition, diabetes, and alcohol use—that accounted for over half of the deaths.
Dr. Greta Wood, from the University of Liverpool, highlighted that the more co-morbidities a person had, the higher their risk of death. Undernutrition and HIV were particularly significant contributors to mortality. She urged urgent action to screen for these conditions and link patients to appropriate treatment.
4. Point-of-Care Testing Speeds Up TB Treatment Initiation
A study by researchers from the University of Cape Town (UCT) demonstrated that point-of-care testing can significantly reduce the time it takes for TB patients to start treatment. The study involved over 7,000 people across four African countries.
Participants who received tests in mobile vans started treatment four days faster than those who had their samples sent to a central lab. This led to a 43% lower probability of treatment initiation failure. Researchers are now conducting transmission modeling to understand the broader impact of this approach.
5. Portable TB Test Shows Promise
Researchers are developing portable, battery-operated devices that can diagnose TB quickly. The MiniDock MTB device, tested across seven countries, showed high accuracy. Sputum swab tests achieved 87% sensitivity, close to the 89% of GeneXpert Ultra, while tongue swabs had 81% sensitivity.
These results meet WHO standards, and the device could provide a low-complexity alternative to traditional molecular testing. Dr. Tessa Mochizuki, from the University of California, San Francisco, emphasized the potential of this technology to bring molecular testing closer to patients.
6. Diagnostic Mask Shows Potential for TB Detection
An innovative diagnostic mask, the Avelo Mask, was tested for its ability to detect TB bacteria in exhaled air. The study involved 58 adults with TB symptoms. The mask, which traps particles from the breath, showed a sensitivity of 71% when compared to GeneXpert Ultra.
While not as accurate as other methods, the mask offers an alternative for individuals who cannot produce sputum samples. Dr. Rouxjeane Venter, from Stellenbosch University, noted that further research is needed to refine this approach.
