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A simple blood test for tuberculosis in children could reduce deaths

Society For General Microbiology : 13 June, 2007  (Technical Article)
TB testing in children is crucial as the disease can rapidly spread from the lungs to other organs, such as the brain, spine and kidneys, leading to life threatening conditions which particularly affect children. A simple blood test to analyse and identify proteins circulating in the blood of infected children could provide the answer.
Latest laser based techniques are helping researchers at Imperial College, London, develop a blood test which should help doctors spot the disease in time, scientists heard at the Society for General Microbiology’s meeting, in York.

Rates of tuberculosis in children living in London have risen 130% over the last ten years, and more TB is being diagnosed there in 10-16 year olds than in any other childhood age group.

“Children are not miniature adults”, says Dr Andrea Hodgetts of Imperial College. “And the tests we have to diagnose tuberculosis in adults don’t work well in children. TB is a major killer around the world, and most research is done on adults. But the screening test for children, using a skin test, doesn’t always work because their immune systems are not yet fully developed, which may not show up a positive result, and repeated testing can give misleading results”.

Using laser enhanced mass spectrometry the Imperial College team has so far only identified the mass (or weight) of the TB marker proteins which circulate through an infected child’s blood, but they shortly hope to pin down their identity, which will make a reliable blood test realistic, easy and cheap enough for widespread use.

“Cost is important in countries where tuberculosis is a major burden, especially in relation to the funds available to tackle it”, says Dr Hodgetts. “Diagnosis is currently so difficult that children may be started on TB therapy as a precautionary measure, without knowing for certain if that is what the child has. By being able to correctly diagnose childhood TB with a simple blood test we will be able to start more appropriate treatment regimes quickly, and spend the money where it is most needed”.

Tuberculosis spreads from person to person through the air, when someone with active TB coughs, talks or sneezes. Mucus and saliva loaded with infectious bacteria can remain airborne for days, spreading over long distances. The bacteria can survive in the air and dust so long as it is dark, direct sunlight kills it in five minutes.

Once inhaled into the lungs the bacteria can reactivate and cause tuberculosis, or remain dormant, surrounded by our immune system’s own defence cells, and re-emerge many years later.

Elderly people with depressed immunity, people on poor diets, a low standard of living, or suffering from overcrowding or infection with HIV can develop the disease when it re-activates, and then spread it to other vulnerable people such as children.
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