Queen Mary research leads the way in tackling tuberculosis

Caused by bacteria, tuberculosis (TB) is the world’s deadliest infectious disease. Predominantly spread by coughing, it is preventable and curable. Nevertheless, to this day, it remains a global public health crisis.

According to the World Health Organization, 10 million people fall ill with TB each year, around 1.5 million of whom die. While the majority of cases are found in low- and middle-income countries, recent data from UKHSA reveals levels are on the rise in the UK. In fact, TB levels are particularly high in East London, where, despite world-class treatment being available, many people die from the disease each year.

Researchers at Queen Mary are at the forefront of changing this picture, both locally and globally. Their work is looking at improving how we understand, diagnose and treat TB, and how patients can get better care. 

Tackling global health inequalities in TB

TB disproportionately affects the most vulnerable populations – not just in our local community, but across the world. Queen Mary researchers are working across the globe to understand how TB impacts different communities – from understanding how TB affects cardiac pathology of people living with and without HIV in Zambia, to the spread and control of TB in Europe following the Russian invasion of Ukraine.

Recently, Dr Dominik Zenner, Clinical Reader in Infectious Disease Epidemiology, has examined the geographical and drug resistance trends of TB within Europe, where almost a third of those with TB were born in, or have citizenship from, a country outside of Europe. His results showed that TB infections had returned to pre-pandemic levels in people originating outside the EU, and note that a strengthened public health response is required to control the spread of TB in an every increasingly mobile world.

He has also examined the post-tuberculosis health and morbidity in high income countries, sharing his opinion The Lancet.

Reflecting on his research into this devastating disease, Dr Zenner said: “My passion to mitigate health inequalities and my academic focus on health needs in underserved populations locally and globally explains my interest in TB. My work seeks to identify pragmatic, feasible, effective and cost-effective ways of early detection and control of this disease which is still the most important cause of death of any infectious disease globally.”

Queen Mary also offers the only postgraduate specialist course in TB in the UK, within the Wolfson Institute of Population Health. 

A new centre of excellence for TB in East London

Our researchers aren’t going it alone. Instead, they’re collaborating with global health experts to address the issue on their doorstep and beyond.

East London has the highest number of newly diagnosed TB cases in Western Europe, and it disproportionately affects the most deprived populations as well as people from South Asian and African backgrounds. With improving the health of our community a core driver of our research, we have partnered with our local NHS Trust, Barts Health, to form a new centre of excellence for TB research and treatment.

Based in the heart of our community and made possible by a £4.63 million donation from Barts Charity, the Queen Mary and Barts Health Tuberculosis Centre brings together leading health experts from both organisations to improve our understanding of TB and drive innovation in treatment and care.

The new Centre will conduct research in a purpose-built laboratory in the Blizard Institute, where work will continue to improve our scientific understanding of TB bacteria and how the human immune system responds to them. Specific projects will focus on:

• developing a new blood test to detect TB infection
• understanding why some patients have ‘flare-ups’ of their symptoms after starting treatment
• investigating genetic factors that influence why people from South Asian backgrounds living in East London may be more likely to be infected by TB

Research-driven clinical innovations developed at the centre will become available to Barts Health patients, including quicker, less invasive ways to collect samples from those suspected to have lung TB, with an aim to reduce treatment delays.

Professor Adrian Martineau, Clinical Professor of Respiratory Infection and Immunity at Queen Mary, said: 

“TB is a major infectious disease that is particularly common in East London. Our vision is to provide step-changes in scientific understanding, diagnosis and treatment of TB, that will be relevant not just to our diverse local community, but also to the 10 million people who fall ill with TB around the world every year.”

The Centre will include the world’s first post-TB clinic to help and treat TB survivors experiencing long-term complications from this debilitating disease will also be established. A dedicated patient and public involvement (PPI) group, led by Amy McConville, a TB survivor and Co-Founder, Chair and Facilitator for the TB Action Group, will be at the core of the Centre’s work,

The new Queen Mary and Barts Health Tuberculosis Centre will build on Queen Mary’s existing body of research to tackle health inequalities in our local communities, and in the wider population, which are exacerbating the rise of TB.

Read more:

• Tuberculosis: an under-recognized cause of COPD? Solving the post-TB lung disease puzzle, one piece at a time
• Post-TB lung disease: keep going beyond TB!
• Tuberculosis in people of Ukrainian origin in the European Union and the European Economic Area, 2019 to 2022
• The burden and natural history of cardiac pathology at TB diagnosis in a high-HIV prevalence district in Zambia: protocol for the TB-Heart study.
• Ultra for diagnosing tuberculosis at bronchoscopy: thoughts on practical applications.
• The treatment of latent tuberculosis infection in migrants in primary care versus secondary care.
• Imaging and circulating biomarker-defined cardiac pathology in pulmonary tuberculosis: A systematic review. 
• Tuberculosis in adult migrants in Europe: a TBnet consensus statement.