Clinical Mycobacteriology and Epidemiology (CLIME) Group
Diagnosis of tuberculosis and drug-resistant tuberculosis
The earlier and more rapid diagnosis of TB is a
key barrier in TB control. CLIME has several projects that aim to evaluate and optimise new tools for the diagnosis of TB or drug-resistance in a variety of patient populations. CLIME is especially interested in developing and evaluating diagnostic technologies that are deployable at the point-of-care, and have high sensitivity in patients with very early stage disease. CLIME is also interested in measuring the impact of new diagnostic tests on patient important clinical outcomes, such as mortality. CLIME conducts diagnostic clinical trials and, through collaborations with national health and laboratory providers, also studies the diagnosis of TB in routine programmatic contexts and how health systems can be strengthened to fully capitalise upon new diagnostic test
Role of the microbiome in tuberculosis
The microbiome is critical in human health but relatively under researched in the context of TB. Early studies indicate that TB infection causes broad, systemic changes to the microbiome in compartments other than the lungs, and that different microbial communities are associated with different risks of progression to active disease. CLIME is currently researching these and other questions, including the association of the microbiome with clinical outcome, relapse, and the long term impact of TB treatment on the microbiome of patients.
The infectiousness of TB patients, and TB transmission
Stopping the person-to-person spread of TB is critical for curtailing the TB epidemic, however, the factors that contribute to the heterogeneity of infectiousness and the success or failure of different strains of TB is poorly understood. CLIME uses several novel aerosol sampling technologies to study the cough aerosol of TB patients and understand the underlying pathobiology of airborne TB bacilli. CLIME also collects and analyses large collections of drug-resistant TB culture isolates, which provide insight into transmission over long periods of time across different regions of South Africa.