Research Roadmap for Tuberculosis Transmission Science: Where Do We Go From Here and How Will We Know When We're There?

• Type of Material: Article
• Authors: Sara Auld, Emory University; Anne G Kasmar, Bill and Melinda Gates Foundation; David W Dowdy, Johns Hopkins University; Barun Mathema, Columbia University; Neel Gandhi, Emory University; Gavin J Churchyard, University of Witwatersrand; Roxana Rustomjee, National Institute of Allergy and Infectious Diseases; Nippie Shah, Emory University
• Language: English
• Date: 2017-10-01
• Publisher: Oxford University Press (OUP): Policy B - Oxford Open Option C
• Publication Version: Final Published Version
• Copyright Statement: © 2017 The Author.
• License: Creative Commons Attribution 3.0 IGO License
• Final Published Version (URL): http://dx.doi.org/10.1093/infdis/jix353
• Title of Journal or Parent Work: Journal of Infectious Diseases
• ISSN: 0022-1899
• Volume: 216
• Issue: suppl_6
• Start Page: S662
• End Page: S668
• Grant/Funding Information: This work is part of a supplement sponsored by the Centers for Disease Control and Prevention and the National Institutes of Health.; The Bill and Melinda Gates Foundation provided funding for participant travel to the workshop. The Centers for Disease Control and Prevention and the South African Medical Research Council co-hosted the corresponding meeting.; This publication and workshop have been funded in whole or in part with federal funds from the Division of AIDS, National Institute of Allergy and Infectious Diseases (NIAID), US National Institutes of Health (NIH), Department of Health and Human Services under contract number HHSN272201100001G—Research Support Services for the Division of AIDS.; Funding support was also provided in part by NIH grants: NIAID R01AI116787 (to D. W. D.) NIAID R01AI089349 (to N. R. G.), NIAID R01AI087465 (to N. R. G.), NIAID K24AI114444 (to N. R. G.), Emory CFAR P30AI050409 (principal investigator: J. W. Curran), and NHLBI T32 HL116271 (principal investigator: D. M. Guidot).
• Keywords: DRUG-RESISTANT TUBERCULOSIS; MULTIDRUG-RESISTANT; MYCOBACTERIUM-TUBERCULOSIS; BURDEN; ISONIAZID PREVENTIVE THERAPY; transmission; PULMONARY TUBERCULOSIS; SOUTH-AFRICA; tuberculosis; public health; Microbiology; PROPHYLAXIS; RESOURCE-LIMITED SETTINGS; Infectious Diseases; Life Sciences & Biomedicine; Immunology; COMMUNITY-RANDOMIZED TRIAL; Science & Technology
• Research Categories: Health Sciences, Public Health; Health Sciences, Immunology

Abstract

High rates of tuberculosis transmission are driving the ongoing global tuberculosis epidemic, and there is a pressing need for research focused on understanding and, ultimately, halting transmission. The ongoing tuberculosis-human immunodeficiency virus (HIV) coepidemic and rising rates of drug-resistant tuberculosis in parts of the world add further urgency to this work. Success in this research will require a concerted, multidisciplinary effort on the part of tuberculosis scientists, clinicians, programs, and funders and must span the research spectrum from biomedical sciences to the social sciences, public health, epidemiology, cost-effectiveness analyses, and operations research. Heterogeneity of tuberculosis disease, both among individual patients and among communities, poses a substantial challenge to efforts to interrupt transmission. As such, it is likely that effective interventions to stop transmission will require a combination of approaches that will vary across different epidemiologic settings. This research roadmap summarizes key gaps in our current understanding of transmission, as laid out in the preceding articles in this series. We also hope that it will be a call to action for the global tuberculosis community to make a sustained commitment to tuberculosis transmission science. Halting transmission today is an essential step on the path to end tuberculosis tomorrow.