Although 95% of the global population of patients with TB still qualify for first line therapy, namely treatment with isoniazid, rifampicin, ethambutol and pyrazinamide, the number of patients with multi-drug resistant TB (MDR-TB) has been growing as a proportion of total incidence.
Tim is conducting a series of observational studies based in Ho Chi Minh City to understanding how we best preserve the efficacy of what is still our most effective and shortest treatment regimen for any kind of TB. Seeking to understand how patients get MDR-TB, Tim is on the one hand performing pathogen whole genome sequencing for a comparative genomic analysis of the burden of MDR-TB transmission, and is on the other hand seeking to understand the contribution of different factors related to the de novo emergence of resistance to first line drugs. To this end, two case control studies are assessing potential selection pressures including undiagnosed resistance to other drugs, pharmacogenomic and pharmacokinetic factors.
These studies will help us understanding how we best preserve the efficacy of what is still our most effective and shortest treatment regimen for any kind of TB. Depending on the findings, potential interventions will include broader ranging and more precise diagnostic approaches, more personalised drug dosing, or more focus on community based public health measures.
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