EDCTP Alumni Network

Fostering excellence and collaboration in the next generation of researchers

Call Career Development Fellowship (CDF)
Programme EDCTP2
Start Date 2021-06-01
End Date 2024-05-31
Project Code TMA2020CDF-3209
Status Active

Title

Selected concise host transcriptional signatures for the blood-based diagnosis of active tuberculosis in an HIV-prevalent setting (RNA-based diagnosis of TB)

Host Organisation

Institution Country
Stellenbosch University South Africa

Current Organisation

Stellenbosch University

Current Job Title

Postdoctoral researcher

Students Supervised

Type Name Title University Start Date End Date
PhD student Welile Dube Ms Stellenbosch University, South Africa 2021 2024

Memberships

Role Committee/board Start Date End Date

Education

Institution Degree Year
University of Cape Town, South Africa PhD 2019-12-12
University of Antwerp, Belgium MSc 2014-07-01

Areas Of Specialisation

Tuberculosis (TB) Lower Respiratory Tract Infections (LRTIs)

Grants

Publications

Authors:
Anna Ojo-Okunola , author
Shantelle Claassen-Weitz , author
Kilaza S. Mwaikono , author
Sugnet Gardner-Lubbe , author
Heather J. Zar , author
Mark P. Nicol , author
Elloise du Toit , author
Date:
2020-05-15
Journal:
Methods and Protocols
Content:
Authors:
Date:
2022-06-27
Journal:
Respiration
Content:

New tuberculosis (TB) diagnostics are at a crossroads: their development, evaluation, and implementation is severely damaged by resource diversion due to COVID-19. Yet several technologies, especially those with potential for noninvasive non-sputum-based testing, hold promise for efficiently triaging and rapidly confirming TB near point-of-care. Such tests are, however, progressing through the pipeline slowly and will take years to reach patients and health workers. Compellingly, such tests will create new opportunities for difficult-to-diagnose populations, including primary care attendees (all-comers in high burden settings irrespective of reason for presentation) and community members (with early stage disease or risk factors like HIV), many of whom cannot easily produce sputum. Critically, all upcoming technologies have limitations that implementers and health workers need to be cognizant of to ensure optimal deployment without undermining confidence in a technology that still offers improvements over the status quo. In this state-of-theart review, we critically appraise such technologies for active pulmonary TB diagnosis. We highlight strengths, limitations, outstanding research questions, and how current and future tests could be used in the presence of these limitations and uncertainties. Among triage tests, CRP (for which commercial near point-of-care devices exist) and computer-aided detection software with digital chest X-ray hold promise, together with late-stage blood-based assays that detect host and/or microbial biomarkers; however, aside from a handful of prototypes, the latter category has a shortage of promising late-stage alternatives. Furthermore, positive results from new triage tests may have utility in people without TB; however, their utility for informing diagnostic pathways for other diseases is under-researched (most sick people tested for TB do not have TB). For confirmatory tests, few true point of- care options will be available soon; however, combining novel approaches like tongue swabs with established tests like Ultra have short-term promise but first require optimizations to specimen collection and processing procedures.
Concerningly, no technologies yet have compelling evidence of meeting the World Health Organization optimal target product profile performance criteria, especially for important operational criteria crucial for field deployment. This is alarming as the target product profile criteria are themselves
almost a decade old and require urgent revision, especially to cater for technologies made prominent by the COVID-19 diagnostic response (e.g., at-home testing and connectivity solutions). Throughout the review, we underscore the importance of how target populations and settings affect test performance and how the criteria by which these tests should be judged vary by use case, including in active case finding. Lastly, we advocate for health workers and researchers to themselves be vocal proponents of the uptake of both new tests and those – already available tests that remain suboptimally utilized.

Authors:
Anna Okunola , author
Stefano Cacciatore , author
Mark P. Nicol , author
Elloise du Toit , author
Date:
2020-02-01
Journal:
Metabolites
Content:
Authors:
Anna Okunola , author
Shantelle Claassen-Weitz , author
Kilaza S. Mwaikono , author
Sugnet Lubbe , author
Dan J. Stein , author
Heather J. Zar , author
Mark P. Nicol , author
Elloise du Toit , author
Date:
2019-06-01
Journal:
Nutrients
Content:
Authors:
Anna Okunola , author
Mark Nicol , author
Elloise du Toit , author
Date:
2018-11-01
Journal:
Nutrients
Content:

Projects

Send a Message