Radboudumc joins 20 million dollar global study on the 'silent' spread of tuberculosis

Backed by nearly 20 million US dollars from Wellcome and the Gates Foundation, Radboudumc is joining a major new international effort to uncover whether people with tuberculosis (TB) who have no symptoms are still spreading the disease. Over the next three years, the ATTIS (Asymptomatic TB Transmission in Indonesia and South Africa) study will help determine whether these ‘silent’ cases are a missing link in global TB control.

ATTIS

The project focuses on KwaZulu-Natal (South Africa) and West Java (Indonesia); regions with some of the highest TB burdens worldwide. Current estimates suggest that around half of people with infectious TB have no complaints. They are not actively looked for in most high-burden countries and often only receive a diagnosis once lung damage has already occurred.

Within ATTIS, researchers will screen tens of thousands of adults in the community, and test children in their households for immune responses to the TB bacterium. This will show how often adults with asymptomatic TB infect others in their own families, how much disease burden they have themselves, and what it would mean – in health impact and costs – if health systems started actively finding and treating them.

Our involvement

Radboudumc infectious diseases specialist Reinout van Crevel has worked on TB in Indonesia for 25 years and is involved in ATTIS in an oversight role, with specific focus on biomarker and mechanistic research. “If people who feel completely well are still driving TB transmission, we may need to fundamentally rethink how we control TB,” he says. “The data from South Africa and Indonesia will be crucial for future WHO policy on whether to actively search for these ‘silent’ cases.”

Radboudumc Global Health event

This new project is part of Radboudumc Global Health and builds on long-standing collaborations with partners in Indonesia and Africa. TB and other global health challenges will also be discussed during the Radboudumc Global Health event on 25 November.