Project Title

From latent infection to active disease: understanding the evolution of tuberculosis disease using Mycobacterium africanum infections in Guinea-Bissau

EDCTP Project Call

Career Development Fellowship (CDF)

Project Objectives

1. To elucidate the clinical and molecular trajectory of TB caused by Mtb or Maf infections and reveal mechanisms of control vs pathogenesis. 2. To enhance the scientific research opportunities and landscape in Guinea-Bissau.

Study Design

Prospective cohort study

Project Summary

Tuberculosis (TB) remains a significant global health challenge, impacting over 10 million individuals annually and causing approximately 1.13 million deaths in 2022. TB can progress to an active state in 5-10% of infected individuals, while the majority harbor a latent infection. The MafTBprogress project aims to elucidate the clinical and molecular progression of TB post-infection. Specifically, it seeks to understand the evolution of the disease, latency, and control through studying the clinical trajectory and whole blood transcriptome of individuals in contact with TB patients. The project focuses on TB caused by Mycobacterium tuberculosis (Mtb) and Mycobacterium africanum (Maf), with a dual aim to enhance scientific research opportunities and the healthcare landscape in Guinea-Bissau. During the second reporting period, follow-up of both index cases and their latently infected contact has been performed. Among close contacts of index cases, 60% (540 individuals) tested positive for latent TB using the IGRA test, while 30% (270 individuals) tested negative. Of the IGRA-positive household contacts of patients infected with lineage 4 (L4), 2.3% (7 individuals) progressed to active disease, 69.2% (213 individuals) remained latently infected, and 28.6% (88 individuals) were lost to follow-up. Among the 215 contacts of patients infected with lineage 6 (L6), 1.9% (4 individuals) progressed to active disease, 67.4% (145 individuals) remained latently infected, and 66 individuals were lost to follow-up. The Maf_TBprogress project advances the understanding of TB's clinical and molecular dynamics, particularly in differentiating the progression and control mechanisms between Mtb and Maf infections. This research provides several key advancements and potential impacts: Enhanced understanding of TB transmission and progression can inform public health strategies, potentially reducing the TB burden in high-incidence regions. Improved tracking and communication strategies for patient follow-up can be adopted in other healthcare initiatives, enhancing overall patient management and care. In conclusion, the Maf_TBprogress project not only furthers scientific knowledge on TB's clinical and molecular evolution but also has significant potential to influence public health strategies and improve patient outcomes, particularly in TB-endemic regions like Guinea-Bissau. The findings from this project are expected to contribute substantially to the global fight against TB by providing a deeper understanding of disease mechanisms and informing effective intervention strategies.

Host Organisation

Current Organisation

Instituto Nacional de Saúde Publica (INASA)

Current Job Title

EDTCP Postdoctoral Researcher

Biography