Researchers at HMS and HSPH have received a $14 million grant from the National Institutes of Health to study multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis. The goal of the project is to better understand the development and transmission of resistant tuberculosis and to identify practical approaches to reducing the public health burden created by this disease. Megan Murray (pictured), a professor of epidemiology at HSPH and an epidemiologist in the Division of Social Medicine and Health Inequalities at Brigham and Women’s Hospital, is the lead investigator.
Rates of MDR-TB and XDR-TB, and the accompanying costs of expensive second-line drug therapies, have increased over the past decade, creating a significant impact on patients, vulnerable communities, and tuberculosis control programs. While inadequate TB control is the primary factor in this increase, more information about the evolution of these strains, how they are transmitted, and which approaches are most effective to control their spread is critical to efforts to stem future growth.
“Treatment of drug-resistant strains of tuberculosis is not only more costly than treatment of drug-sensitive strains, but it is also more complex and therefore less likely to be successful,” said Murray, also an HMS assistant professor of medicine at Massachusetts General Hospital. “For all these reasons, growth in the incidence of drug-resistant tuberculosis poses a very real threat to tuberculosis control programs.”
The grant will fund three interconnected research projects. The first, to be conducted in Peru, will involve a large field study to generate data on the microbial and host determinants of transmission of drug-sensitive and drug-resistant tuberculosis and will also develop an archive of MDR and XDR tuberculosis strains. The second project will examine the archived strains for genetic and metabolic causes of strain diversity, and the third will use field and lab data to develop mathematical models of tuberculosis transmission and the effect of interventions to create prediction models to guide future drug regimens.
Mercedes Becerra, HMS assistant professor of social medicine; Paul Farmer, the Maude and Lillian Presley professor of social medicine at HMS; and Lucila Ohno-Machado, HMS associate professor of radiology at BWH, will colead the projects.
