MHF TOP PICKS FOR April
Every month, we at the Mueller Health Foundation like to showcase interesting news and updates in the field of tuberculosis. Below are our top 3 picks for April:
- Surge of HIV, Tuberculosis and COVID Amid War in Ukraine
Ukraine has one of the world’s highest burdens of multidrug-resistant (MDR) TB. An estimated 32,000 people there develop active TB each year, and about one-third of all new TB cases are drug-resistant. Twenty-two per cent of people in Ukraine with TB are infected with HIV, and TB is the leading cause of death among those living with HIV. The current conflict poses additional risks for increasing the number of drug-resistant TB cases since any interruption of TB treatment can lead to MDR-TB. Additionally, interrupting treatment for MDR-TB makes it more possible to develop extremely drug-resistant TB, where there are few or no drugs available that work. Diagnosis and treatment of TB cases had already plunged by about 30% during the COVID-19 pandemic in 2020 and 2021, leading to increased transmission. The continued conflict will further fuel the public health crisis in the Ukraine, which will ultimately affect neighboring countries and the European region as a whole. To learn more, you can access the full article at: https://www.nature.com/articles/d41586-022-00748-6
- Tuberculosis Induces Premature Cellular Aging
A new study published recently by researchers at Baylor College of Medicine found that the cells of humans and animals who have recovered from tuberculosis had prematurely aged up to 12 to 14 years. In this study, the researchers studied multiple cohorts and multiple tissue types and discovered that tuberculosis induced perturbations in epigenetic regulation, specifically in the regulation mediated by DNA methylation. These changes correlated with oxidative stress-induced senescence and were associated with premature cellular aging. These processes were observed across both guinea pigs and humans. Looking ahead, according to one of the study’s researchers, the impact of the findings could be that a multi-omic epigenetic clock assay could become part of the standard of care for infectious diseases and further inform increased risk for comorbidities after chronic conditions or environmental exposure To learn more, you can read the full article here: https://www.aging-us.com/article/203936/text
- Shorter Treatment for Nonsevere Tuberculosis in African and Indian Children
Researchers from the MRC Clinical Trials Unit at UCL worked with partners in South Africa, Uganda, Zambia and India on the SHINE study, the first randomized control trial to assess whether children with non-severe tuberculosis could be effectively treated with a shorter course of treatment. The trial involved 1,204 children aged two months up to 16 years with non-severe TB, who were divided randomly into two groups to take either four or six months of treatment with anti-TB medicines. Of the enrolled children, 11% were living with HIV. All children were followed for 18 months after enrollment to see whether their treatment had been successful. The results clearly showed that children who received the shorter course did as well as those on the standard six-month treatment, regardless of the age group, country, or HIV status, with few and similar side effects in both groups. To learn more, you can access the full article here: https://www.nejm.org/doi/10.1056/NEJMoa2104535
DID YOU KNOW?
In the 19th century, Rhode Island was considered to be the “Vampire Capital of America”. Between the late 1700s and the 1890s, vampire superstitions were prevalent in New England. This was also around the time that tuberculosis, a disease people referred to as “consumption”, claimed many lives in the New England communities.
In the 1800s, before scientists were able to better understand and explain tuberculosis, it was common for the average lay person to think that people who were dying of tuberculosis were having the life sucked out of them by a supernatural creature, such as a vampire. Back then, this belief was strongly supported by the observations that people suffering from (untreated) tuberculosis lose weight, become physically weak, have fevers, and cough up blood.
The most famous story is that of Mercy Brown in Exeter, Rhode Island. She was believed to have been the first female vampire and her story reflects the bizarre belief system and inhumane practices of the time.
Mercy Brown died of tuberculosis in 1892, and in the weeks after her death, her brother Edwin began suffering the symptoms of tuberculosis. Less than two months after Mercy died, the people of Exeter exhumed her body, as well as those of her mother and sister, who had also died of tuberculosis years earlier. Because so many people in the same family had died of the disease, the townspeople suspected a vampire was at work. When they found Mercy’s body to be more intact than those of her relatives, so they decided she was a vampire, removed the heart, burned it, and fed the ashes to Edwin. Not surprisingly, he died shortly thereafter of the tuberculosis he already had.
Fortunately for modern medicine, scientists were beginning to accept germ theory towards the end of the 19th century, and Robert Koch identified and studied the bacterium that causes tuberculosis, paving the way for a later vaccine and treatment options. The case of Mercy Brown marked the end of tuberculosis-associated vampire prevention rituals in New England.