Our focus
In the Region of Southern Denmark, we have gathered leading experts in the treatment and research of diseases caused by mycobacteria within MyCRESD.
Tuberculosis (TB) occurs worldwide and is the infectious disease responsible for the most deaths globally. It is estimated that a quarter of the world’s population is infected with Mycobacterium tuberculosis, of which about 10% will develop active TB, posing a risk to both their own and others' health.
It is still not possible with traditional biomarkers to identify which of the healthy TB carriers will develop active TB. We hypothesize that a new type of blood biomarkers—microRNA, cytokines, and chemokines—can be used to identify the carriers who are at the highest risk of developing active TB.
In a national study, involving TB centers from all Danish regions, we will include healthy TB carriers and follow them for two years with regular clinical and blood tests. We will look for differences in biomarker profiles between carriers who develop TB and those who remain healthy. We expect the results to enable the development of a risk score, allowing us to target treatment for TB carriers at the highest risk of developing active TB.
Delayed TB diagnosis can be due to either doctor- or patient-related factors, and this issue has not yet been systematically investigated in countries where the incidence of TB is low. We hypothesize that delayed TB diagnosis primarily affects socially disadvantaged patients and patients with TB in organs other than the lungs, and that such delays will have health consequences for treatment duration and prognosis.
Based on the inclusion of newly diagnosed TB patients nationwide, we aim to explore factors associated with delayed TB diagnosis and evaluate its significance. We will characterize the disease entity TB among patients with delayed TB diagnosis. We expect that the overall results will contribute to developing a more efficient diagnostic and treatment pathway for TB patients in Denmark.
Globally, delayed and missed TB diagnosis leads to significantly increased morbidity and mortality among patients also infected with HIV. In this context, we hypothesize that implementing a new validated rapid diagnostic test, "TB LAM," performed on a urine sample, could allow doctors to start TB treatment during the first consultation for HIV patients who are also found to be infected with TB.
We expect that this will contribute to improved outcomes for a highly vulnerable and at-risk patient group. We will evaluate the effect of "TB LAM" in a cluster-randomized study at three major HIV clinics in Ghana. The project builds on a well-established collaboration with the University of Ghana and will form the basis for a unique HIV/TB cohort with a biobank for further research.
Simultaneously, as more patients are diagnosed with primary and secondary immunodeficiencies, the incidence of patients with non-tuberculous mycobacterial (NTM) disease is rising—even in high-income countries. Treatment of NTM infections can take several years, and the disease is associated with high mortality. We will use national clinical and microbiological databases to describe the incidence of NTM and identify the factors crucial to patients' diagnosis, treatment, and prognosis.
We aim to strengthen our current position in research on mycobacterial infections within the ongoing clinical research center for mycobacterial infections in Denmark. The synergy between national and international research in such a center will help us get closer to the goal of eradicating TB in Denmark, profiling TB research in high-endemic areas, and improving TB and NTM patient care through personalized medicine.