Whole Blood Mycobacterial Growth Assays And Tuberculosis Susceptibility Öffentlichkeit
Colvin, Tucker (Summer 2023)
Abstract
Background: Developing a valid and simple biomarker test to predict tuberculosis (TB) susceptibility is necessary for reversing recent trends and ending TB. Whole blood mycobacterial growth assays (WBMGA) have demonstrated potential to be used in low resource settings in order to direct screening and preventative care to those most at risk. While WBMGA have been linked to determinants of TB, this thesis explores the association between WBMGA results and the risk of incipient TB disease.
Method: A secondary analysis was conducted with the permission of Innovation for Health and Development (IFHAD) in Lima, Peru on an anonymous, unlinked dataset. Participants were healthy, TB-negative adults who were close contacts of TB index cases.
Results: Mycobacterial growth in blood relative to plasma at or below the median log difference in luminosity of 0.53 relative light units (RLU) was significantly associated with a 3.0 (95% confidence interval= 1.0, 8.0) times increase in risk of developing TB disease within six months (p=0.031).
Conclusions: The results from this analysis demonstrate the potential of WBMGA to be used as a predictive tool of TB susceptibility within six months. Future research is necessary to explore the implementation of WBMGA for use in point-of-care risk evaluation and its potential contribution to the global campaign against TB.
Table of Contents
Introduction 1
Definition of terms 2
Literature Review 3
Determining who is at Risk of TB 4
Importance of biomarkers in disease control and eradication 6
Importance of cost and ease of use in TB control 6
The search for TB biomarkers 7
The potential of WBMGA 8
Objectives 14
Methods 15
Sample population 15
Measuring mycobacterial growth 16
Assessing the relationship of WBMGA results and operational variables 17
Assessing the relationship of WBMGA results and variables associated with TB 17
Incorporating long-term TB epidemiological follow-up data 18
Analysis Strategy 18
Ethical considerations 19
Results 20
Mycobacterial growth in each medium 20
Selecting a comparison for growth in blood 22
WBMGA association with operational, demographic, and TB-associated variables 23
Outcome of interest: Secondary TB 24
Survival analysis 26
Proportional hazards assumption for incipient TB 27
Discussion 27
Limitations 29
Conclusion 30
References 30
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