Strategies for the management of multidrug-resistant tuberculosis in Kampala, Uganda
Project
Tuberculosis is a major global health problem but the burden is disproportionately high in developing countries. Further, ineffectual national control programmes, inadequate drug supply, availability of anti-tuberculous medications over-the-counter, and patient non-compliance lead to drug resistance. Multidrug-resistant tuberculosis (MDR-TB), defined as TB resistant to at least the two most effective drugs, now affects nearly all regions and countries globally and poses an increasing problem in many settings. Additionally, co-infection with HIV dramatically increases the spread of TB, including the prevalent MDR strains, both in the community and on hospital wards.
This programme aims to develop affordable treatment regimens for patients with MDR-TB and inexpensive approaches to prevent the spread of the disease in hospitals. To that end, the programme will:
- determine the prevalence of primary and secondary drug resistance in TB patients treated in the National TB and Leprosy Control Programme (NTLP) at Mulago Hospital, Kampala
- determine the extent of transmission of drug resistant TB at the hospital and identify host and microbial factors that predict transmission
- evaluate new interventions to reduce transmission of drug resistant TB.
MDR-TB is expensive to treat, so interventions shown to be cost-effective in Uganda could readily be adapted to tackle this emerging threat in many other developing country settings.
Applicants
Professor J J Ellner
Centre for Emerging Infectious Diseases, University of Medicine and Dentistry of New Jersey, Newark, USA
Professor R S Wallis
University of Medicine and Dentistry of New Jersey, Newark, USA
Dr D L Hom
University of Medicine and Dentistry of New Jersey, Newark, USA
Dr L B Reichman
National Tuberculosis Center, University of Medicine and Dentistry of Jersey, Newark, USA
Professor R Mugerwa
Makerere University Medical School, Kampala, Uganda
Dr A Okwera
National TB Treatment Center, Old Mulago Hospital, Kampala, Uganda
Dr F Adatu
National TB Leprosy Program, Kampala, Uganda
Dr T Aisu
Department of Microbiology, Mulago Hospital, Kampala, Uganda
Professor P G Smith
Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, UK
Mr M Quigley
Infectious Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, UK