Our current research objectives are improving TB diagnosis, treatment and prevention by carrying out clinical trials of new diagnostic tests, therapeutic approaches and vaccines. We also aim to understand the mechanisms by which both host and pathogen influence disease severity, treatment responses and outcomes using human macrophage models and omics technologies.
We focus on four research areas:
Clinical and Epidemiology team members include study doctors, study nurses, study coordinators and data coordinators. The team’s responsibilities are working at hospitals and district TB units to recruit participants, making clinical assessments, taking samples, and follow-up until the end of the study. We conduct observational studies, clinical trials and epidemiological studies covering a wide range of new TB diagnostic methods and treatment approaches. The team also has specific project on epi-genomics of drug resistance and diagnosing and treating TB meningitis in children.
Bacterial lab team members include lab technicians, research assistants and PhD/post-doc scientists. The team works in our laboratories at OUCRU (clinical lab, Bio-Safety Level 2 and Level 3 labs). They are responsible for running all the microbiological lab tests (diagnosis tests, drug-susceptible and tolerance testing) required by all studies and managing many types of clinical samples. Some of these tests are routine TB tests; some are novel tests which are still in the development and research stage.
Cell-Immunological lab team members work in our labs at OUCRU to perform cellular and molecular experiments to study molecular determinants of pathogenesis and outcome in pulmonary and meningeal tuberculosis. The team is using cutting-edge technologies, including multi-omics, single-cell genomics and cell infection models to understand disease mechanisms and improve patient outcomes.
Data team members include research assistants and PhD/post-doc scientists who are establishing pipelines to analyse multi-omic data. The team is integrating clinical and laboratory data to identifynew biomarkers for treatment monitoring and new targets for host-directed therapy.
Associations between cell size and structure and drug resistance have been shown (Vijay et al Front Microbiol 2017 & 2018), whilst the spread of the Beijing lineage and positive selection of the EsxWBeijing variant in Vietnam have also been demonstrated (Holt et al Nature 2018); Sources of multi-drug resistance (Vijay et al CID 2020); Risk factors for poor treatment outcomes of multidrug-resistant TB (Van et al BMC 2020). 2021 WHO catalogue of Mycobacterium tuberculosis complex mutations associated with drug resistance: A genotypic analysis (Walker et al Lancet Microbe 2022). The effect of M. tuberculosis lineage on antibiotic resistance and clinical outcomes (Duc et al PLOS GPH 2023, Silcocks et al Microbiol Spectr 2023, Stanley et al Lancet Microbe 2024, Culviner et al Cell 2025).
We defined the use of GeneXpert MTB/RIF in the diagnosis of TBM (Nhu et al JCM 2014) and pediatric TB (Giang et al BMC 2015). The largest prognostic study to date of mortality in TBM with 1699 cases (Thao et al CID 2018 & 2020) identified predictors for increased mortality. Xpert MTB/RIF Ultra for the diagnosis of TBM (Donovan et al Lancet ID & CID 2020). Rapid identification of drug-resistant TB(Tram et al JCM 2023 & 2024); Proof-of-concept evidence of using host gene signatures in blood to diagnose TB meningitis (Huynh et al JID 2024); Improving sputum decontamination and storage method (Quang et al Wellcome Open Research 2025). Cepheid 3-gene host response and multibiomarker test using fingerstick blood for PTB diagnosis (Sutherland et al CID 2022, Sutherland et al CID 2025).
Human Leukotriene A4 Hydrolase (LTA4H) genotype was found to determine TBM susceptibility and predict the effectiveness of adjunctive dexamethasone (Tobin et al Cell 2010 and 2012, Thuong et al JID 2017).. Effect of bacterial burden on inflammatory response and outcome (Thuong et al JID 2019, Hai et al Tuberculosis 2021). Omics associated with TBM pathogenesis and mortality (Ardiansyah et al Elife 2023, Hai et al 2024, Nhat et al Med 2025, Tram et al JI 2025)
Dexamethasone (now endorsed by WHO for TBM treatment) saves more lives (Thwaites et al NEJM 2004); timing of ARVs does not influence survival (Torok et al CID 2011); intensified TB therapy improves survival in INH-R TBM (Heemskerk et al NEJM 2016, Heemskerk et al CID 2017); phase 2 trial of adjunctive aspirin for TBM (Mai et al Elife 2018); dexamethasone trial in TBM in HIV positive adults (Donovan et al NEJM 2023); new guidelines for TBM (Donovan et al Lancet 2025)
Thuong NTT, Heemskerk D, Tram TTB, et al. Leukotriene A4 Hydrolase Genotype and HIV Infection Influence Intracerebral Inflammation and Survival From Tuberculous Meningitis. J Infect Dis. 2017;215(7):1020-1028. https://pubmed.ncbi.nlm.nih.gov/28419368/
Mai NT, Dobbs N, Phu NH, et al. A randomised double blind placebo controlled phase 2 trial of adjunctive aspirin for tuberculous meningitis in HIV-uninfected adults. Elife. 2018;7:e33478. https://pubmed.ncbi.nlm.nih.gov/29482717/
Van LH, Phu PT, Vinh DN, et al. Risk factors for poor treatment outcomes of 2266 multidrug-resistant tuberculosis cases in Ho Chi Minh City: a retrospective study. BMC Infect Dis. 2020;20(1):164. https://pubmed.ncbi.nlm.nih.gov/32087682/
Tram TTB, Ha VTN, Thu DDA, et al. Variations in Antimicrobial Activities of Human Monocyte-Derived Macrophage and Their Associations With Tuberculosis Clinical Manifestations. Front Cell Infect Microbiol. 2020;10:586101. https://pubmed.ncbi.nlm.nih.gov/33194825/
Sutherland JS, van der Spuy G, Gindeh A, et al. Diagnostic Accuracy of the Cepheid 3-gene Host Response Fingerstick Blood Test in a Prospective, Multi-site Study: Interim Results. Clin Infect Dis. 2022;74(12):2136-2141. https://pubmed.ncbi.nlm.nih.gov/34550342/
Walker TM, Miotto P, Köser CU, et al. The 2021 WHO catalogue of Mycobacterium tuberculosis complex mutations associated with drug resistance: A genotypic analysis. Lancet Microbe. 2022;3(4):e265-e273. https://pubmed.ncbi.nlm.nih.gov/35373160/