According to the World Health Organization, tuberculosis now kills more people worldwide than HIV/AIDS, and cases of the disease have increased in Texas. In 2015, there were more than 1,300 cases of tuberculosis reported in the state.
As part of KERA’s Breakthroughs project, Lauren Silverman talks with Dr. Tawanda Gumbo, a researcher at Baylor who's coming up with new ways to tackle a very old disease.
In most of the U.S., Tuberculosis is almost a forgotten disease. What is the concern?
“Tuberculosis is, I would say, I’m biased of course, the most important nemesis of mankind, for centuries. It’s in our literature: When you look at, say, "La boheme," at the heroes and heroines there, it’s all tuberculosis. It's been there in our founders, like George Washington, in great people like Nelson Mandela; it's been with mankind forever. Because it’s so widespread it kills so many people — up to 3 percent of all deaths in many places — which is more than war, road traffic accidents all put together.”
How is tuberculosis treated today?
“We have what are called first-line treatments for TB, which are four standard drugs that have been used since the 1970s. These drugs were designed for treatment of TB of the lung, for adults. And then were sort of adapted for use in children. But, they actually don’t work as well in those other groups of people. And now when you have drug resistant TB on top of it, you can't use the first line kind of drugs. You have to use second-line type of drugs, which are more toxic for the adults and for the children. For example in one study, 25 percent of children treated with one of the standard drugs, the second-line drugs, went deaf.”
If there aren’t good treatments developed for children, what was the work you published in the Clinical Infectious Diseases journal?
“So, what we actually did, was to say ,'let's treat the most common manifestations of this disease in children.' It’s less the coughing kind of disease. They get diseases like meningitis, which is infection of the brain lining, and the covering of the heart, the pericardium. So we took into account what type of medications can penetrate into all these different sites that are peculiar to disease of children. And second, we took into account that metabolism. And now we put these together in such a way that there is synergy, and then added a third drug. That’s the third innovation. The fourth [innovation] is they’re all orally available and can be made into syrups, so they’re child-friendly formulations.”
Will you proceed with clinical trials of the drug regimen you developed?
“Yes, there’s a group in one of the former Soviet Republics where there’s already a very high rate of multidrug-resistant TB, and they want to do a feasibility study where they just give this regimen. We [also] do a lot of work in South Africa ,and we actually want to do a head-to-head study of this and a current standard of care.”