Leading the way for improved tuberculosis diagnostics

In 2018 the World Health Organisation reported 10 million cases of tuberculosis globally, causing 1.3 million deaths every year. Indonesia ranks third in the number of tuberculosis cases and every year 842,000 new cases are diagnosed.

This project is developing knowledge about tuberculosis, and its associated fungal diseases called chronic pulmonary aspergillosis (CPA) and chronic pulmonary histoplasmosis (CPH). The ambition is to create the means (a chest X-ray and simple antibody test) to identify susceptible groups and outbreaks much faster and therefore curb the number of people dying from these diseases or being misdiagnosed.

As well as pioneering studies of the population, this project is collecting blood samples and H. capsulatum isolates – a form of fungi – which are essential to develop new diagnostic tools for CPA and CPH, and to determine histoplasmosis endemic regions.

The work in Indonesia is leading the world, and will change management approaches to tuberculosis in the long term, especially in cases that are not cured or resistant to treatment by shedding light on associated fungal infections so that people can be treated properly.

This work stimulated the Foundation for Innovative Diagnostics in Geneva to initiate a major programme on CPA in India. Similar work is ongoing in Pakistan, Nigeria, Brazil, Kenya and Guatemala. China is engaging with the problem of CPA and tens of thousands of cases are being diagnosed and treated there, which was not the case just three years ago.

"These results have global implications for tuberculosis programs – simple antibody testing and chest X-rays can diagnose chronic fungal infection after tuberculosis."

Professor David Denning, University of Manchester