Amid disease headlines, global TB progress takes place in Tanzania

Despite the present focus on COVID-19 and monkeypox, tuberculosis remains one of the most lethal infectious illnesses in the world. The World Health Organisation predicts that tuberculosis will kill over 1.5 million people by 2020. For the first time in over a decade, tuberculosis mortality increased that year.

Doctors and scientists at the University of Virginia School of Medicine, on the other hand, are making significant progress in their long-standing efforts to better understand, prevent, and treat tuberculosis, and they have received a $1.25 million boost for collaboration with colleagues in Tanzania to train the next generation of front-line soldiers in the disease's war.

The role of malnutrition in Tuberculosis

The researchers' findings show the major influence of starvation on global tuberculosis. The UVA researchers and their Tanzanian collaborators explain how malnutrition and gut infections impair tuberculosis therapies for young children in a recent article published in the scholarly journal The Lancet Microbe. 

The researchers discovered that children with frequent gut infections have lower amounts of important TB medications in their bodies, and the higher the concentration, the more infections they have. Researchers anticipate that based on these groundbreaking findings, practitioners may be able to target gut bacteria to improve tuberculosis treatment outcomes.

"Historically, the patient and a lack of drug adherence were blamed for tuberculosis treatment failure," said Dr. Scott Heysell of the University of Virginia's Division of Infectious Diseases and International Health. "Instead, other microbes in underprivileged children's intestines contribute to insufficient levels of critical drugs, even when administered as prescribed." Some of the gut bacteria that cause malnutrition and predispose to malnutrition-related tuberculosis also make tuberculosis treatment more difficult."

According to the study, malnutrition is a significant contributor to tuberculosis. As per the authors of a paper published in the scientific journal The Lancet Infectious Diseases, malnutrition is a "major risk factor" for contracting the disease. They believe there is an urgent need to understand how nutritional deficiencies weaken the immune system. This information would provide valuable insight into how famine and "undernutrition" affect the efficacy of tuberculosis immunizations and therapies.

"It is time for governments, non-governmental organisations, charitable foundations, and academia to be energised rather than terrified by the work at hand," write Heysell and his co-authors. "Research and funding must be expedited," they write. "The payback might be massive." Malnutrition elimination investments are expected to have long-term effects that reach far beyond their impact on tuberculosis and can be revolutionary, particularly in low-income areas. According to a Haitian saying, "doing tuberculosis treatment without providing food is like washing your hands and then drying them in the mud."

Future generation education

The National Institutes of Health's Fogarty International Centre has awarded the University of Virginia scientists a $1.25 million grant to enhance long-standing training cooperation with their Tanzanian counterparts, based in part on the new tuberculosis discoveries. The critical funding will allow the cooperation to educate Tanzania postdoctoral researchers on the link between malnutrition and tuberculosis.

The Division of Infectious Diseases and the Centre for Global Health Equity at the University of Virginia trained a total of 177 overseas students at various academic levels throughout the previous decade. Almost 90% of those people are still working in research.

According to Heysell, prioritising international trainee education in global health benefits everyone. We can do more to follow in the footsteps of young scientists from underserved areas.

One of the program's strengths is its diversity. Eleven of the teachers are from the University of Virginia, while the remaining seven are from Tanzania. Eight of the people are female. This enables the programme to connect postdocs with Tanzanian mentors as well as secondary UVA mentors, providing trainees with access to a wide range of expertise and knowledge. Heysell will lead the programme, together with Dr. Stellah Mpagama, head of research and innovation at Tanzania's Kibong'oto Infectious Diseases Hospital and adjunct faculty at UVA, and Dr. Maria Kamm, Tanzania's Best Female Scientist for 2022.

"Through this initiative, Tanzanians will be able to create research leaders who will help the government achieve its 'End TB' goal," Mpagama said. The joint research we've done over the last decade has greatly educated us on the numerous hurdles to TB prevention. The next stage is to establish cures and research leaders to ensure that scientific efforts to combat this recurrent disease continue. "