- Should TB patients be quarantined in hospital or treated at home?
- What are the legal and ethical implications?
- How can the newest TB drugs best be managed to avoid triggering resistance in TB bacteria?
- What are the most effective ways of using the latest genomic techniques and information to combat TB?
These are just some of the questions that are becoming ever more critical as extensively drug-resistant (XDR) TB looms on Australia’s horizon—it’s already in Papua New Guinea. They are also examples of the issues to be discussed on Thursday 2 May and Friday 3 May at the first symposium of the new NHMRC-funded Centre of Research Excellence in Tuberculosis Control, located at the Centenary Institute.
The aim of the meeting is to help decide what project areas the Centre—launched a little more than a month ago—should tackle first. And there’s plenty of interest, says the Centre’s inaugural director Professor Warwick Britton, who also heads Centenary’s Tuberculosis Research Group. The symposium has attracted nearly a hundred researchers, academics and doctors from all over Australia.
“At present,” says Professor Britton, “we typically manage TB patients at home, as their family members are usually already infected. But if we got an XDR patient, they would be likely kept in hospital until their infection was controlled—up to five months would not be unusual.” At the moment, there are different approaches and legislation for treating drug-resistant TB patients in the different States. “We want to develop an evidence base for making such decisions and recommendations to government,” Prof Britton says.
In Australia we limit the availability of TB drugs to use in TB patients, but in many high burden countries TB antibiotics are used inappropriately for other infections and this may fuel the development of drug resistant TB strains. It may be necessary to establish controls on dispensing drugs for treating TB, including the small number of second-line antibiotics we have to treat drug resistant TB. “Governments may need to put limitations on pharmacies to ensure that TB drugs are used only for treating TB.” Enforcing such rules may well raise legal and ethical problems.
“Our best defence against XDR-TB would be to set up long-term support for a program of TB control in PNG and our region in order to prepare ourselves to take care of the TB patients that land in Australia.” That’s why the Centre for Research Excellence involves researchers from 14 institutes based in New Zealand, Indonesia, Vietnam, China and Fiji, as well as Australia.
For further information on the CRE for TB Control visit: www.tbcre.org.au or http://www.centenarynews.org.au/a-boost-in-the-fight-against-the-killer-on-our-doorstep/
Toni Stevens on 0401 763 130 or firstname.lastname@example.org