A definitive treatment marker for tuberculosis
Two to three million people die worldwide from Tuberculosis bacillus (TB) every year. The fight against TB has been taken up by the 'Establishing a TB treatment efficacy marker' (TB Treatment Marker) project in Guinea-Bissau where there is one of the highest incidences of TB in the world. TB Treatment Marker scientists aimed to identify a method to gauge the efficacy of different TB treatment programmes. The result will be the more appropriate use of drugs and an overall decrease of TB incidence. To date, if primary treatment is seen to be unsuccessful, a time-consuming, rigorous analysis identifies further antibiotics that may be taken. Previous research has indicated that soluble urokinase plasminogen activator receptor (suPAR) may be used as a treatment efficacy marker. Concentrations of the blood plasma protein are elevated when TB is active and decrease when the patient responds positively to therapy. Use of suPAR confers many advantages. It can be tested in blood, serum, plasma and urine using the inexpensive enzyme-linked immunosorbent assay (ELISA) method. In settings where TB is most common, normally in relatively remote, third country regions, it is important that the test is portable and low-cost. The TB Treatment Marker initiative, also known as treaTBest, conducted a clinical investigation in Guinea-Bissau to determine if suPAR did decline when treatment was effective and if it can be used as part of the prognosis. Taking into account the long-term consequences of various infections, health conditions and interventions, the researchers aimed to determine the most important factor – the critical time that suPAR can be used in a clinical decision regarding further treatment. One of the main project achievements was the rebuilding of the country's TB testing facilities after destruction in the civil war in 1998. After successful design of the study, data has been collected for further analysis. TB Treatment Marker also focused on education and capacity development for the fight against the disease in a rural context.
