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Coughing may not be the primary driver of TB transmission: new study

The disruption to TB services during the pandemic has only highlighted just how important it is to make testing for and treating TB simpler and easier to access.

covid-19, breathlessness, lung infectionThe development of a fast and accurate, non-sputum-based point-of-care triage test for tuberculosis would have a major impact on combating the TB burden worldwide. (Source: pixabay/file)

The virtual 52nd Union World Conference on Lung Health, which opened on Tuesday, announced major scientific developments that will potentially impact the global response to tuberculosis (TB).

This year, the event takes place against the backdrop of the ongoing Covid-19 vaccine inequity, with the pandemic continuing to impact the delivery of TB services in many low-income and middle-income countries.Today, Covid-19 and TB are the two most fatal infectious diseases in the world.

The novel coronavirus pandemic has refocused attention on how infectious diseases are transmitted from person to person and has catalysed innovations in sampling and diagnostics. The disruption to TB services during the pandemic has only highlighted just how important it is to make testing for and treating TB simpler and easier to access.

On the opening day of the conference, researchers from the University of Cape Town announced results from their study of TB patients carried out in the specially-constructed Respiratory Aerosol Sampling Chamber which suggest that coughing — thought previously to be the main means of spreading TB — might not be the primary driver of TB transmission. Instead, tidal or regular breathing may be a far more significant contributor to the aerosolization of Mycobacterium tuberculosis, the bacterial cause of TB.
“This study is an important step forward in our understanding of aerosol transmission of disease and its findings are as relevant for Covid-19 as they are for TB,” said Guy Marks, president of The Union and convenor of the World Conference, in a statement issued on Tuesday.

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Lead author of the study, Ryan Dinkele of the University of Cape Town, said if tidal breathing was a primary driver, or even as important as cough in TB transmission, then symptomatic screening for TB-transmitters may not be useful in slowing the spread of the disease.

“The current approach, which relies on testing and treatment of passively identified individuals, may not be a reliable response to preventing transmission, as it depends on people feeling sick enough to seek treatment,” said Dinkele. “It may also shed light onto why constructing transmission chains is so challenging in high-TB burden settings.”

Finger stick blood test can detect TB in less than an hour
The development of a fast and accurate, non-sputum-based point-of-care triage test for tuberculosis would have a major impact on combating the TB burden worldwide.

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A new finger stick blood test has been developed by Cepheid. The device is the first to meet the WHO target product profile for a triage test for TB regardless of HIV status or geographical location. It takes under one hour and uses finger stick blood, rather than sputum, which reduces biohazard risk and increases likelihood of diagnosis in individuals who cannot readily produce sputum, such as children and people living with HIV.

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First published on: 20-10-2021 at 02:26:54 am
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