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TB Treatment Marker


Establishing a TB Treatment Efficacy Marker
Framework programme:
Project number:
EC contribution:
€ 375,104
24 months
Starting date:
1 January 2005

Keywords: Tuberculosis; treatment efficacy marker; SuPAR; capacity building; poverty related diseases; prognostics; clinical study


Worldwide, tuberculosis bacillus (TB) has reached epidemic proportions, with rising infection rates calling out for immediate and effective action. Globally, approximately 2-3 million people die, and more than 7-8 million people develop active TB on a yearly basis.

Currently, no method exists to monitor successfully the efficacy of TB treatment. Upon diagnosis, patients are treated for TB with a course of medication lasting approximately six to nine months. Prior to the end of the treatment regime, there exists very little indication of the efficacy of the particular treatment. In the event that the individual is found resistant to primary treatment, a stringent and time-consuming analysis is undertaken to select the appropriate antibiotics effective for that particular patient as a second-line treatment.

It has previously been shown that the blood plasma protein suPAR (soluble urokinase Plasminogen Activator Receptor) is elevated in patients with active TB, carries prognostic value during the treatment period, and that suPAR levels decrease in patients that respond to therapy. This published data indicates that suPAR could possibly be used to guide clinical decision-making in HIV and TB management.

Guinea-Bissau has one of the highest incidences of TB in the world (about 470 cases for every 100 000 adults). However, as in other developing countries, markers of disease progression and/or treatment efficacy are difficult to find, especially if tests are to be inexpensive, technically simple and require very little advanced equipment.

The Bandim Health Project, a research programme holding a demographic health surveillance system covering five districts in Bissau (with a population of about 75 000) provides an optimal location to investigate if the serum level of suPAR is a useful marker for TB treatment efficacy. Amongst other objectives, the project aims to provide a basis for the monitoring of TB progression and TB treatment efficacy, as well as to provide TB treatment for study participants.

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