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Grants enable researchers to study effects of TB in children
Author: FMHS Marketing & Communications / FGGW Bemarking & Kommunikasie – Sue Segar
Published: 16/03/2021

Dr Marieke van der Zalm was recently awarded three international grants collectively valued over R44 million to study various aspects of tuberculosis (TB) and lung health in children.

Two of the grants are from the National Institutes of Health (NIH) in the United States and the other one is from the European & Developing Countries Clinical Trials Partnership (EDCTP). Each of the grants are for a period of five years.

Van der Zalm, who works for the Desmond Tutu TB Centre, situated in the Department of Paediatrics and Child Health, is the principal investigator (PI) of a large prospective observational study cohort that aims to improve the diagnosis of TB in children, as well as to investigate the long-term consequences of TB and other respiratory pathogens in young children. The three grants are all linked to this cohort that was established in 2017 by Dr van der Zalm and Dr Liz Walters.

The NIH-R01 grant, valued at $1 455 808 (over R22 million) was awarded for the research study, Multiplexed Antigen-Specific Antibody Fc Profiling on a Chip for Point-of-Care Diagnosis of TB in HIV-infected Children, done in collaboration with Professor Galit Alter and colleagues at Harvard University. Van der Zalm will be the local PI and will recruit an additional group of 300 South African children with suspected TB in order to develop a blood-based point-of-care test to diagnose TB in especially the youngest children that are HIV exposed or infected, by investigating Mycobacterium tuberculosis antibody responses.

In addition, Van der Zalm received the NIH K43 'Emerging Global Leader' award, valued at $565 867 (R8.5 million) for research entitled The long-term consequences of pulmonary tuberculosis and respiratory viruses on lung health in young South African children.

“There is more and more evidence that adults, despite being microbiologically cured from TB, suffer long-term consequences, including pulmonary impairment. However there is no data in children. It is very important to investigate this in children as their lungs are still developing, and therefore, TB events early in life could have long-lasting consequences on their lung health," Van der Zalm said.

Lastly, they also received the EDCTP Senior Fellowship Plus, which will run from 2021-2026 and is valued at €750 000 (over R13 million), to build capacity in research on child lung health in South Africa and Mozambique. This grant builds on the same cohort established partly by her previous EDCTP career fellowship (2017-2020).

Van der Zalm, who trained as a paediatrician in the Netherlands, where she also completed a PhD on respiratory viruses, moved to South Africa in 2013 and started working at the Desmond Tutu TB Centre in 2014. She then became involved in a range of different TB studies and developed her own areas of interest, particularly in investigating the long-term consequences of TB and other respiratory diseases on lung health in children.

Together with colleagues at SU's Faculty of Medicine and Health Sciences she was also involved in the Covid-Kids study, aimed at defining the clinical presentation, immune response and long-term consequences of respiratory virus infections (including SARS-CoV-2) in children presenting at Tygerberg Hospital during the pandemic.

“At the moment there's a lack of reliable tools to diagnose TB in young children especially those who are living with HIV. In our research we will look at blood-based markers that can help us differentiate between children that have TB and those who don't, to help us prevent the unnecessary deaths of children not diagnosed in time with TB. We believe that successful outcomes of this research could be a game-changer," said Van der Zalm.

She said the research would involve the development of a point-of-care test – using a drop of blood that can be put into a machine at the bedside, the aim of which would be to provide a quick answer as to whether the person has TB or not. 

“It has been a tough year for everyone as a result of the Covid-19 pandemic. These grants are a recognition of the importance of the work that we are doing. These grants will give us the opportunity to establish important paediatric data to improve the diagnosis and the long-term impact of TB in the coming five years," said Van der Zalm. She also expressed delight at the awarding of the three grants, which would make this research possible.