Tuberculosis (TB) is one of the top 10 causes of death, globally. The World Health organisation’s (WHO) Global Tuberculosis Report released last year, estimates that in 2017, TB caused 1.3 million deaths among HIV-negative people, and there were an additional 300 000 deaths from TB among HIV-positive people. There were an estimated 10 million new cases of TB.
TB is the leading cause of death in South Africa. In 2017, with the population sitting at 57 million, 22 000 people died from TB. The 19 districts with the highest burden are spread out across eight of the country’s nine provinces. In the Western Cape, the City of Cape Town and the West Coast remain most affected. The reported incident rate in the province is 681 per 100 000. The stats are dire.
TB is spread through the air from one person to another in small droplets that contain the bacteria. This can happen when someone infected with active TB speaks, sings, spits, laughs, coughs, or sneezes. Restricted ventilation, such as cramped and poor living conditions including prisons, exacerbate the condition.
As an opportunistic infection it is activated when the immune system is weakened. The most vulnerable are the poor, young, aged, pregnant women, HIV-infected people, mine workers and prisoners.
TB research has been intensified to address questions aimed at prevention, diagnosis and treatment. The University of Cape Town (UCT’s) Institute of Infectious Disease and Molecular Medicine (IDM), based in the Faculty of Health Sciences (FHS) is one of the world’s leading research centres on infectious disease. To commemorate World TB Day, the IDM hosted their 2nd Annual World Tuberculosis Day NanoSymposium to showcase research conducted by leading scientists and researchers in the field. The programme included a line-up of UCT researchers as well as keynote speaker Professor Bryan Bryson from MIT/Harvard.
“The idea was to have people who are working on different aspects showcase their research data and advances they have made in combating this disease, with a specific focus on new research that they had not yet published,” said Dr Sabelo Hadebe, one of the three organisers of the event. This refers to research where there are ongoing advancements – like the promising research into adolescents that SATVI (the South African Tuberculosis Vaccine Initiative) shared last year which hadn’t yet been published at the time.
The event’s theme, ‘Intervening along the spectrum of TB II’ was carried over from 2018.
Co-organiser Dr Mohlopheni Marakalala says that the spectrum referred to in the theme ranges from prevention (through vaccine development), transmission, diagnostics, treatment (new therapies), drug resistance, and the impact of HIV co-infection.
“Last year there were people speaking on various aspects of the infection cycle – and its different stages. Some tackled the different drugs that are available, some focused on how the bacteria acquires different mutations and becomes resistant, others looked at the various clinical trials that are happening, or transmission, or the impact of starting ARVs or host-directed immune boosting to fight TB. That’s where the idea came from – people looking at different aspects or niches of the cycle. People intervening at different parts of the cycle – whether they’re at the beginning or the end of it.”
Opportunities such as this symposium are important spaces for researchers to engage on their work with colleagues who may not necessarily be aware of these activities.
Hadebe says, “It also offers the chance to be updated about what interventions are taking place; whether in clinics or on the bench.”
IDM Director, Professor Valerie Mizrahi, said that the intention this year was to showcase the new generation of work and talent. While last year’s event had senior Principle Investigators (PIs) presenting, this year it was mainly early-career researchers that were featured on the programme.
The highlight was Professor Bryson’s presentation on his work combining new technologies with classical approaches. The Poster session and the dinner offered early-career researchers an opportunity to engage with Professor Bryson, with the hope that this would start conversations for new and future collaborations on TB research.
An additional highlight is that the TB NanoSymposium will be featured in the Scientific African, a new open access journal that seeks to publish innovative research by African researchers.
“It’s with incredible passion that people are progressing TB research,” said Prof Mizrahi in her concluding remarks. “That’s because we’re living with it. It’s incumbent on all of us to think about why we’re doing what we’re doing. And remember, that at the end of the day, it’s about TB patients.”
“Ultimately, one of the things we want to do is put ourselves out of business.”