MRCG’s Tuberculosis Case Contact (TBCC) platform identifies new TB cases through household contact studies

Each year, it is estimated that 10.4 million people develop active TB disease, but 4.3 million of these individuals are missed each year by health systems and do not get the TB care they need and deserve. Without proper treatment, up to two-thirds of people ill with TB will die. In addition, people who are ill with TB can infect up to 10 to 15 people with whom they are in close contact in a single year. This means that each missed case can expand the current TB burden, which compounds the challenge to end TB.

tbcc-platform1The TBCC platform is a long-running study incorporating several significant biomarker projects looking at protective immunity to TB. It allows longitudinal analysis of all exposed household contacts to an index case, including adults and children. Due to the life cycle of TB, around 10% of HIV-negative contacts will progress to active TB within their lifetime. This long-term active follow-up enables a much higher rate of detection of progression to active TB amongst contacts.

The entire TBCC team includes the Head Clinician Dr Olumuyiwa Owolabi, all field workers who actively go to households at multiple times throughout the study period (in all kinds of weather/road conditions) and the laboratory team who help to diagnose. In addition, the national TB control program provides an essential role in referring both primary and secondary TB cases to MRCG.

Samples from these subjects provide key information on immunity to TB: a paper was published in Lancet in 2016 detailing a Ribonucleic acid (RNA) – a signature that could identify TB patients at least 1 year prior to disease progression. The future focus is now to validate this signature, identify mechanisms and develop a test that can be used in a prospective study to identify those subjects most in need of therapeutic interventions.