MDR-TB a focus of scientific research at the Union World Conference

The Union World Conference brought together scientists and researchers to share their knowledge and insights in scientific sessions, a predominant theme being how best to tackle drug-resistance.

At a session entitled ‘Resistance to TB drugs: new moves and what next?’ Renaud Boulanger of McGill University spoke about the ethical and political challenges for new TB drugs and diagnostics. He referenced a study participant saying, “large populations, mostly poor and disregarded, are more likely to contract the disease and are less likely to get to any treatment, even if the technological part becomes available.”

Not paying attention to ethical and political challenges puts us at risk of not maximising the technologies we are developing and implementing. He called for health system strengthening, clear criteria for who is eligible for the drug, and clarity about how it fits into care delivery.

Kalpana Sriraman from the Foundation for Medical Research, Mumbai, described her work on analysing the genes associated with multidrug-resistant tuberculosis (MRD-TB). She suggested that future research could be done on how to use genes to identify the types of TB that acquire drug resistance during treatment.

At an afternoon session on improving patient care in MDR-TB, Carolina Kwok of TB Access spoke about the gaps in patient treatment and diagnosis in Lesotho. She emphasised how, in a country with one of the highest rates of TB globally, understanding gaps in TB care is essential. Kwok identified the challenges that need to be addressed including; irregular methods of sample collection, issues with communication between laboratories and facilities, and poor methods of capturing data.

Kei Alegria-Flores from University of North Carolina at Chapel Hill spoke about applying a behavioural model to the treatment of patients with drug-resistant TB in Peru. Adapting a model used widely in treatment of diabetes and HIV, the study evaluated whether this method could inform the design, monitoring, and evaluation of MDR-TB treatment. They were able to conclude that, with appropriate psychosocial support, it successfully predicted patients’ adherence to drug-resistant TB treatment.

Finally, Dr Refiloe Matji spoke about a study on the management of MDR-TB, looking at the transition from hospital to community-based treatment in Bangladesh. Having evaluated patient outcomes across several sites, their findings suggest that the community based management of MDR-TB showed a great potential for Bangladesh to increase access to quality services. The results suggested that a high cure rate with minimal treatment interruption and failure is achievable.