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Malnutrition, diabetes, total patient costs and post-TB sequalae in patients starting Anti-TB treatment in the Philippines.

In this cohort study we are investigating the effect of undernutrition and diabetes on TB treatment outcomes, including during 2 years of post-treatment follow-up. Total patient costs during treatment are also being prospectively collected.  The cohort is providing a platform for further studies investigating the management of diabetes in TB patients; quality of life and depression and effects on TB treatment adherence. Participants are being recruited from 3 regions in the Philippines: Metro Manila, Cebu and Negros Occidental. 

Project dates: August 2018 - July 2022

Project lead and staff: Sharon Cox, Tansy Edwards, Mishal Khan, Anna Vassall and Yoko Laurence

Collaborating institutions: Nutrition Center Philippines; National TB Programme of the Philippines; Nagasaki University, Japan

Funder: Japan Ministry of Science, Culture and Sport, KAKENHI &  Nagasaki University

MRC-KHIDI UK-Korea Partnering Awards:Building investigator links for studies on the roles of complement C1q and endoplasmic reticulum (ER) stress in macrophage polarisation during Mycobacterium tuberculosis infection

ER stress and C1q would play important roles inducing inflammatory/anti-inflammatory response against Mtb infection by modulating M1/M2 phenotypes polarisation, however, the connection between ER stress and C1q in the early stages of Mtb infection and changes in their links in chronic (long-term) Mtb infection, particularly its association with macrophage polarisation, have not been investigated. Here, we will investigate roles and relationships of C1q and ER stress, and whether these may exert similar or opposing effects on macrophage control against Mtb in terms of balanced polarisation of M1/M2 phenotypes.

Project dates: April 2019 - 20 September 2020

Project lead and staff: Jackie Cliff, Ji-Sook Lee, Steven Smith, Theresa Ward and John Raynes

Collaborating institutions: Chungnam National University, S.Korea (CoPI;  Chang-Hwa Song)

Funder: Medical Research Council (MRC)

Multi-drug resistant tuberculosis in Zimbabwe: impact of the disease on the livelihoods of patients and their households, and possible mitigatory factors

This PhD project will investigate the effect of MDR-TB on livelihood of patients and their families compared to control household no affected by TB in a very challenging economic  environment. In addition a process evaluation of the cash transfer program for MDR-TB patients operating since 2013 will be conducted.

Picture of a landscare in Zimbabwe

Project dates: April 2019 - December 2022

Project lead and staff: Collins Timire (PD student), Katharina Kranzer (supervisor)

Collaborating institution: Biomedical Research and Training Institute

Funder: NIH (Fogarty Fellowship)

National MDR-TB advisory services

A survey of different mechanisms to monitor and evaluate MDR-TB care within Europe. 

Project dates: April 2019 - April 2022

Project lead: Graham Bothamley

Collaborating institutions: TBnet-ERS Clinical Research Collaboration:  AIGHD, Amsterdam, Netherlands; RRPCPTB, Belarus; DGHSM, Harvard, USA; Research Centre, Borstel, Germany; San Rafaele, Milan, Italy; KKJM, Bochum, Germany; ICDDRB, Dhaka, Bangladesh; LIIU, Cape Town, South Africa; REUH, Riga, Latvia; NRCM/MSF, Paris, France; PDCH, Porto, Portugal

Funder: European Research Council (ERS)

Optimizing health systems to improve delivery of decentralized care for patients with drug-resistant tuberculosis

This project uses analysis of patient pathways to understand how DRTB care has been decentralised in three provinces of South Africa, aiming to identify what health system factors contribute to effective DRTB care.

Project dates: February 2016 - January 2020

Project lead: Alison Grant

Collaborating institutions: University of Cape Town, AHRI, UKZN, South African MRC, QMU

Funder: Medical Research Council (MRC)

Performance of immune-based and microbiological tests in children with TB meningitis in Europe – a multi-centre Paediatric Tuberculosis Network European Trials Group (ptbnet) study

Tuberculous meningitis (TBM) is often diagnostically challenging. Only limited data exist on the performance of interferon-gamma release assays (IGRA) and molecular assays in children with TBM in routine clinical practice, particularly in the European setting. 

Project dates: until December 2020

Project lead: Robin Basu Roy

Collaborating institutions: ptbnet ( Paediatric Tuberculosis Network European Trials Group )

Relationship between migration and MDR-TB in Europe

Migration both to and within Europe is associated with MDR-TB treatment.  This survey is to explore the reasons behind these movements and the effect on national health-care systems.

Project dates: October 2018 - October 2021

Project lead: Graham Bothamley

Collaborating institutions: TBnet-ERS Clinical Research Collaboration:  AIGHD, Amsterdam, Netherlands; RRPCPTB, Belarus; DGHSM, Harvard, USA; Research Centre, Borstel, Germany; San Rafaele, Milan, Italy; KKJM, Bochum, Germany; ICDDRB, Dhaka, Bangladesh; LIIU, Cape Town, South Africa; REUH, Riga, Latvia; NRCM/MSF, Paris, France; PDCH, Porto, Portugal 

Funder: European Respiratory Society (ERS)

Strategic Partnership to deliver on Sustainable Development Goals Health and Wellbeing targets

The aim of the project is to undertake an assessment of the main health priorities of the communities living around the mines using an SDG 3 framework. This implies to undertake a baseline data assessment for each health indicator listed under SDG3. Both quantitative and qualitative methods will be used to complete this appraisal and to investigate what are the social and environmental factors that shape the health of these communities. Evidence generated will be used to inform the design of ad hoc biomedical and structural interventions tailored around the needs of these populations to improve priority health indicators and make sure they are on track to achieve the set targets.

Project dates: January 2019 - December 2019

Project lead and staff: Mitzy Gafos, Brian Rice, Delia Boccia, Daniel Carter and Mariken de Wit

Collaborating institutions: In countries academic and NGOs partners

Funder: Anglo American Group Foundation