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New tools and approaches to drug-resistant TB | Collections | MSF Science Portal
New tools and approaches to drug-resistant TB

New tools and approaches to drug-resistant TB

The World Health Organization estimates that 410,000 people developed a drug-resistant tuberculosis infection (DR-TB) in 2022, only 40% of whom were diagnosed and started on treatment—and only 63% then cured. Given all these points of failure, innovation in preventing, diagnosing and treating DR-TB cannot come fast enough.

To mark World TB Day (24 March 2024) the content collection linked below highlights recent work by MSF and collaborators to help change this grim picture. The TB-PRACTECAL and endTB studies delivered robust evidence for shorter, safer, more effective drug regimens that are already saving lives worldwide. Other studies explore new approaches to preventive treatment and simpler, quicker, accurate detection of TB and drug resistance—especially among difficult-to-diagnose populations such as children and people living with HIV.

But to impact DR-TB globally these innovations must become widely accessible. This requires changes on many fronts, as described in an accompanying Collection (Expanding Access to Lifesaving New TB Tools).

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Climate change and health

Climate change and health
The climate crisis is also a health and humanitarian crisis, disproportionately impacting people in the world’s most climate-sensitive regions—mainly low- and low-middle income countries with the least capacity to respond. MSF and other humanitarian organizations witness the consequences daily. More frequent, intense weather events and a warming planet contribute to food and water scarcity, more severe and widespread disease outbreaks, and more injuries and preventable deaths. They also drive massive population displacement, with over 32 million people fleeing their homes in 2022 alone due to floods, drought, storms and fire—nearly triple the number displaced by violence and conflict. As global leaders convene in Dubai for the UN climate conference (COP28, 30 Nov-12 Dec 2023) we present this cross-section of work by MSF and collaborators, drawing from first-hand experience at our medical projects. Emphasizing the urgency of adapting humanitarian operations to the climate crisis, the collection also explores loss and damage through a health lens, proposes policies and practices for creating climate-resilient health organizations, and advocates for embedding fair, just ethics perspectives into humanitarian action and research on climate.
World Hepatitis Day 2022

World Hepatitis Day 2022
Safe abortion care at MSF

Safe abortion care at MSF
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Each year hundreds of millions of people suffer from chronic or acute liver disease caused by hepatitis viruses, and over one million die. To mark World Hepatitis Day (July 28th) we bring you a selection of MSF research exploring how to better prevent, identify and treat hepatitis infection in lower-income countries and emergency contexts where the burden is heaviest. For example, in a South Sudanese camp for displaced people—a type of setting where poor sanitation and water quality regularly lead to hepatitis E outbreaks—MSF and the Ministry of Health (MoH) are conducting the world’s first reactive vaccination campaign against this disease, and evaluating the process and outcomes. In Cambodia, MSF and MoH collaborators found that a simplified community-based model of care for hepatitis C was safe and highly effective in diagnosing patients and in curing them with new antiviral drugs. It was also cost-effective, according to studies in several countries and patient populations. And these new drugs were safe and effective even in patients also being treated for drug-resistant tuberculosis.

Unsafe abortion is a major cause of maternal death, and the only one that is completely preventable. Yet over 30 million unsafe abortions occur each year, leading to at least 29,000 deaths and millions of serious complications—nearly all in low- and middle-income countries. MSF teams see these tragic consequences first-hand, treating thousands of patients every year with severe, potentially life-threatening effects from unsafe abortion.


To mark International Safe Abortion Awareness Day (28 September 2024), this Collection presents highlights of MSF’s work on safe abortion care (SAC) as a way to reduce maternal death and injury. By re-assessing and reshaping how our projects deliver SAC in fragile and conflict-affected settings, we have been able to significantly expand services in those contexts and across MSF projects globally. In parallel, we also conducted in-depth studies of abortion complications and their contributing factors in fragile settings, where a dearth of evidence limits understanding of women's needs in accessing comprehensive care. These findings are helping to identify gaps in service delivery and inform operational decision-making.

Journal Article
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Research

Short oral regimens for pulmonary rifampicin-resistant tuberculosis (TB-PRACTECAL): an open-label, randomised, controlled, phase 2B-3, multi-arm, multicentre, non-inferiority trial

Nyang'wa BT, Berry C, Kazounis E, Motta I, Parpieva N,  et al.
2024-02-01 • Lancet Respiratory Medicine
2024-02-01 • Lancet Respiratory Medicine
BACKGROUND
Around 500,000 people worldwide develop rifampicin-resistant tuberculosis each year. The proportion of successful treatment outcomes remains low and new treatments are nee...
Journal Article
|
Research

Nine-month, all-oral regimens for rifampin-resistant tuberculosis

Guglielmetti L, Khan U, Velasquez GE, Gouillou M, Abubakirov A,  et al.
2024-01-29 • medRxiv
2024-01-29 • medRxiv

BACKGROUND

Aft...

Journal Article
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Research

Detection of Mycobacterium tuberculosis complex using the Xpert MTB/RIF Ultra assay on the stool of pediatric patients in Dushanbe, Tajikistan

Rekart ML, Mun L, Aung A, Gomez D, Mulanda WK,  et al.
2023-01-09 • Microbiology Spectrum
2023-01-09 • Microbiology Spectrum
We report the findings of a prospective laboratory diagnostic accuracy study to evaluate the sensitivity, specificity, and predictive values of the Xpert MTB/RIF Ultra assay for Mycobact...
Conference Material
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Slide Presentation

Pregnancy outcomes in patients undergoing drug-resistant tuberculosis treatment in two closely monitored cohorts

Lachenal N, Hewison CCH, Berry C, Mitnick CD, Ahmed SM,  et al.
2022-05-11 • MSF Scientific Days International 2022
2022-05-11 • MSF Scientific Days International 2022
Conference Material
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Abstract

Can point-of-care ultrasound support tuberculosis diagnosis in children? The experience of MSF in Guinea-Bissau

Moreto-Planas L, Sagrado MJ, Mahajan R, Gallo J, Biague E,  et al.
2022-05-11 • MSF Scientific Days International 2022
2022-05-11 • MSF Scientific Days International 2022
INTRODUCTION
Tuberculosis (TB) is an important cause of morbidity and mortality in children and over 50% of childhood TB remains undiagnosed every year. As microbiological confirmati...
Journal Article
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Commentary

Being heard on all-oral therapy for resistant tuberculosis

Furin J, Isaakidis P
2022-05-02 • Lancet Infectious Diseases
2022-05-02 • Lancet Infectious Diseases
Journal Article
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Research

Feasibility and acceptability of using the novel urine-based FujiLAM test to detect tuberculosis: A multi-country mixed-methods study

Rucker SCM, Lissouba P, Akinyi M, Lubega AV, Stewart RC,  et al.
2022-05-01 • Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
2022-05-01 • Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
BACKGROUND
The novel urine-based FujiLAM test identifies tuberculosis in HIV-positive patients but may be challenging to use at point-of-care (POC).

OBJECTIVES
We assess...
Journal Article
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Research

Whole genome sequencing has the potential to improve treatment for rifampicin-resistant tuberculosis in high burden settings: a retrospective cohort study

Cox HS, Goig GA, Salaam-Dreyer Z, Dippenaar A, Reuter A,  et al.
2022-02-16 • Journal of Clinical Microbiology
2022-02-16 • Journal of Clinical Microbiology
BACKGROUND
Treatment of multidrug-resistant or rifampicin-resistant tuberculosis (MDR/RR-TB), although improved in recent years with shorter, more tolerable regimens, remains largely...
Journal Article
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Commentary

Tuberculosis preventive therapy for children and adolescents: an emergency response to the COVID-19 pandemic

Mohr-Holland E, Douglas-Jones B, Apolisi I, Ngambu N, Mathee S,  et al.
2021-03-01 • Lancet Child and Adolescent Health
2021-03-01 • Lancet Child and Adolescent Health
Journal Article
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Commentary

Introducing new and repurposed TB drugs: the endTB experience

Seung KJ, Khan UT, Varaine FFV, Ahmed SM, Bastard M,  et al.
2020-10-01 • International Journal of Tuberculosis and Lung Disease
2020-10-01 • International Journal of Tuberculosis and Lung Disease
In 2015, the initiative Expand New Drug Markets for TB (endTB) began, with the objective of reducing barriers to access to the new and repurposed TB drugs. Here we describe the major imp...