Abubakar Ibrahim, Lipman Marc, McHugh Timothy D, Fletcher Helen
Centre for Infectious Disease Epidemiology and MRC Clinical Trials Unit, University College London, London, UK.
UCL-TB, University College London, London, UK.
BMC Med. 2016 Mar 23;14:47. doi: 10.1186/s12916-016-0599-1.
Tuberculosis is a major global cause of morbidity and mortality. Despite recent advances in containing the epidemic, several challenges continue to slow progress towards elimination including the continuing impact of drug resistant disease, and the lack of appropriate tools. Curtailing the transmission of tuberculosis remains a challenge especially in high burden countries. New developments in measuring correlates of protection are urgently needed to support the evaluation of vaccines. Similarly, despite progress in molecular diagnostics, better tools are required to identify resistance to antibiotics in multi and extensively drug resistant tuberculosis. Whole Genome Sequencing may lead to the next generation of assays to rapidly detect resistance and evaluate transmission. Advances on shortening treatment are hampered by the lack of a biomarker of cure which obviates the current long wait for relapses in trials. New research is urgently needed to support development of new vaccines and better diagnostics tools and shorter treatment for drug sensitive and resistant tuberculosis.
结核病是全球发病和死亡的主要原因。尽管近期在控制疫情方面取得了进展,但仍有若干挑战继续阻碍着结核病消除工作的进展,包括耐药疾病的持续影响以及缺乏适当的工具。遏制结核病传播仍然是一项挑战,尤其是在高负担国家。迫切需要在测量保护性相关指标方面取得新进展,以支持疫苗评估。同样,尽管分子诊断取得了进展,但仍需要更好的工具来识别耐多药和广泛耐药结核病中的抗生素耐药性。全基因组测序可能会带来新一代检测方法,以快速检测耐药性并评估传播情况。缩短治疗时间的进展受到缺乏治愈生物标志物的阻碍,这使得目前在试验中等待复发的时间过长。迫切需要开展新的研究,以支持开发新疫苗、更好的诊断工具以及针对药物敏感和耐药结核病的更短疗程治疗。