Accra, March 30 GNA- The Noguchi Memorial Institute for Medical Research (NMIMR) of the University of Ghana, has been working closely with key stakeholders including the National Tuberculosis (TB) Control Programme (NTP), in the fight against TB.
These collaborations have been through research, training, awareness creation and support to persons living with TB.
Since 1999, starting with funding from the Japan International Cooperation Agency (JICA), the Institute has supported the NTP through building laboratory capacity within the Ghana Health Service and offering specialised diagnostics services.
It also conducted a situational analysis of all districts across the country in terms of capacity for TB diagnosis that informed the development of the laboratory system and manuals, and also supported the national surveillance study that determines the true burden of the disease in Ghana.
Professor Dorothy Yeboah-Manu, the Director, NMIMR, in an interview with the Ghana News Agency (GNA), said TB was the number one infectious disease killer until the COVID-19 pandemic.
It is caused by the germ mycobacteria released by an infected person through coughing, singing, talking and sneezing, and people mainly get infected by breathing in air droplets containing the germ expelled by an infected person, but infection can also be through eating or drinking an infected animal product such as unsterilized cow milk,
She said some of the signs and symptoms of TB include, coughing, night sweats, chest pains, unintentional weight loss and general fatigue.
Prof. Yeboah-Manu who is also the Head of the TB research laboratory stated that the Institute continues to support a rapid diagnosis of cases using the NTP established Sputum Transport System and also pursues drug susceptibility testing to detect drug-resistant cases while strengthening the culture to sustain monitoring of response to TB medication.
Although TB is treatable using a cocktail of four antibiotics for six months, people continue to suffer and die from the disease as a result of ignorance, late diagnosis, stigmatization, poor adherence of patients to treatment regimen and low investment to support research and treatment among others.
She said available statistics show that globally, 10 million people get sick annually with TB of which, about 1.5 million die, meaning that over 4,100 people die daily from TB, with approximately 30,000 others falling ill, and in Ghana, “it is estimated that up to 40 people die of TB every day”.
Much progress has been made globally since the year 2000 through research and advocacy, resulting in an estimated 66 million lives being saved, however disruption in health delivery services due to the COVID-19 pandemic has reversed the trends and for the first time in a decade, there was an increase in TB death in 2020, she said.
Consequently, there is an urgent need to invest resources to ramp up the fight against TB and achieve the commitments made by global leaders and other stakeholders to end TB by 2030, and that is why the Institute commemorates the 2022 World TB Day, by calling for increased investment in research and TB control activities to save more lives.
Dr Adwoa Asante Poku, a Senior Research Fellow at the NMIMR, speaking on some of the research activities of the Institute, stressed the importance of understanding the biology of the TB germ, for which the NMIMR has progressive knowledge showing that the disease, is caused by 10 closely related germs called the Mycobacterium Tuberculosis Complex (MTC), some of which infect animals, and others humans or both.
She said occasionally, the animal variant such as Mycobacterium bovis that causes TB in cattle can also infect humans, although TB in humans is mainly caused by the MTC variant, to develop effective control tools such as vaccines, a lot of studies have been, and are still being conducted on this germ.
Another variant of the MTC called the Mycobacterium Africanum causes TB in only West Africans because this germ is restricted to West Africans, but not many studies have been done on it.
Thus the NMIMR is leading the global research into the germ. “We are studying the genome to see differences in the DNA composition compared to the global germ, Mycobacterium tuberculosis,” she said.
Dr Asante Poku, said such studies are important for understanding the behaviours and characteristics of the germ, and for the design of diagnostics and vaccines for TB control.
Noguchi, she said, has conducted some analysis of mutations for drug resistance, host susceptibility and risk factors for disease transmission, adding that “some of our findings show that there are hotspots of transmission in Greater-Accra,” she said and advises individuals with signs and symptoms of TB to seek early medical attention.
Improving TB diagnosis among children:
She mentioned another research area of Noguchi is towards improving TB diagnosis in children, which is challenging due to the difficulty in collecting phlegm as a sample for diagnosis, and this affects early diagnosis and treatment.
Consequently, diagnosis is based on signs, symptoms, and history of TB contact, leading to increased child mortality due to undiagnosed TB or wrong treatment.
Researchers are now studying different laboratory detection systems such as using blood or urine, and detection of markers of TB infections, and when completed the efforts will contribute towards the development of blood or urine-based rapid TB diagnostics for children, she said.
TB and Diabetes
Dr Asante Poku said the relationship between TB and diabetes has received little attention, especially in low-income countries, where 75 per cent of diabetic patients live and are also battling the illness.
She said through the NMIMR, Ghana is assessing the role of diabetes in the occurrence and response to the treatment of TB, which is a partnership between the Department of Chest Diseases and the diabetics’ clinic at the Korle-Bu Teaching Hospital. “We also periodically sensitise and screen the diabetic patients for early detection and subsequent potential treatment for TB”.
TB in animals
The NMIMR has contributed immensely to research into Bovine TB (TB in cattle), a disease of public and animal health, which has received little or no attention despite its impacts on livestock and humans.
Dr Asante Poku said in close collaboration with the veterinary services division (VSD) of the Ministry of Food and Agriculture, NMIMR has conducted several studies to support TB control activities using the One Health approach in Ghana.
“Our findings indicate that there is the transmission from animals to animal handlers, and approximately one per cent of human TB in Ghana is caused by spread from animals to humans. This calls for increased collaboration between the NTP and VSD for TB control,” she stated.
Again based on findings from their research, periodic community outreach and engagement activities are organised in transmission hotspots for early case detection and community awareness creation of the diseases.
TB is a public health scourge, a health security threat, and a development challenge, and sustained investment is key to accelerating efforts towards finding the missing TB cases within communities across the country, improving research, public awareness and education on early screening, diagnosis and treatment; and ending stigmatization to save more lives and achieve the Sustainable Development Goals.
GNA