PA-583 Revolutionising tuberculosis treatment response monitoring and developing research capacity in Africa: progress and potential of the tuberculosis molecular bacterial load assay

• Published in: BMJ global health 2023-12, Vol.8 (Suppl 10), p.A99-A99
• Main Authors: Sabiiti, Wilber, Musisi, Emmanuel, Mtafya, Bariki, Mbelele, Peter, Azam, Khalide, Ntinginya, Nyanda Elias, Kuchaka, Davis, Kamdolozi, Mercy, Khosa, Celso, Ssengooba, Willy, Rachow, Andrea, Henreich, Norbert, Sloan, Derek J, Joloba, Moses, Davies, Gerry, Aarnouste, Rob, Boeree, Martin, Hoelscher, Michael, Kibiki, Gibson Sammy, Gillespie, Stephen H
• Format: Article
• Language: English
• Subjects: Abstracts of Poster and e-Poster Presentations; Bacterial infections; Medical research; Medical treatment; Tuberculosis
• ISSN: 2059-7908
• DOI: 10.1136/bmjgh-2023-EDC.241

BackgroundTuberculosis (TB) treatment is long and complex. Here we summarise data from EDCTP-funded studies of the Tuberculosis Molecular Bacterial Load Assay (TB-MBLA) as a TB treatment monitoring tool.MethodsTreatment naïve participants from four Sub-Saharan African countries were assessed for TB diagnosis and treatment response using TB-MBLA compared to liquid culture (MGIT) and other standard-of-care tests. ResultsDiagnostic accuracy assessment using MGIT as gold standard showed TB-MBLA sensitivity, specificity, positive-and-negative-predictive values were 99%, 91%, 92% and 99% respectively among presumptive TB cases. TB-MBLA turn-around-time (clinic-laboratory-clinic) was 6log10eCFU/mL, was associated with failure to convert to negative by month-2 of treatment. Resolution of TB-MBLA-measured sputum bacillary load mirrored cough resolution, reduction of C-reactive protein levels in blood and correlated with MGIT culture time-to-positivity (Spearmans r= -0.5, p500 clinical/laboratory scientists trained in principles of molecular diagnostic development and implementation globally.ConclusionThe data shows that TB-MBLA is a robust assay for TB treatment response monitoring and anti-TB drug development. It has contributed to research capacity building across Africa and beyond.