Susan Dorman, M.D., an infectious disease physician at the Medical University of South Carolina (MUSC), was recently awarded a 10-year, $9.9 million contract by the Centers for Disease Control and Prevention to run trials for the Tuberculosis Trials Consortium" (TBTC). The TBTC is a collaboration of researchers whose goal is to improve the diagnosis, management and prevention of tuberculosis (TB) around the world. Dorman, who has dedicated her career to studying the disease, serves as a TB medical consultant for the South Carolina Department of Health and Environmental Control and leads research efforts to improve TB treatment and prevention.
"In the U.S., we think of TB as a disease of the past (...). However, in many other parts of the world, it is still a contemporary health problem that impacts people's lives." -- Dr. Susan Dorman
"In the U.S., we think of TB as a disease of the past, and we do have good TB control in this country," Dorman explained. "However, in many other parts of the world, it is still a contemporary health problem that impacts people's lives in terms of morbidity and mortality."
According to the World Health Organization, TB is one of the top 10 leading causes of death in low-income countries. That's why Dorman has a long-term collaboration with a research team at the University of Cape Town Lung Institute in South Africa, where TB is very common. For one of the TBTC projects, she will partner with the Cape Town team to test TB treatment interventions in an area where people are severely affected by the disease.
The leaders of the TBTC will set the research agenda for funded investigators and ensure it is relevant both globally and in the U.S. In this country, social disparities in health care are contributing factors to TB infection and transmission. People living in poverty and crowded living environments are at a higher risk for TB transmission. Lack of access to proper nutrition can increase disease susceptibility, and health care costs can negatively affect treatment outcomes. Future work from the TBTC will attempt to address strategies for better managing TB and latent TB in underserved populations in the U.S.
Although TB is curable, Dorman said, it is a challenging course of treatment that can involve six months of antibiotics, with more than one antibiotic often being taken at the same time. The treatment can be difficult for patients to complete and can lead to side effects. One component of this funded work would be to shorten the treatment duration to improve the likelihood of patients completing it.
Another hurdle to effective management of the disease is latent TB infection. The bacterium that causes TB can live inside people for years without causing any signs or symptoms. Later in life, they can 'wake up' and cause sickness, and so it is important that we have effective tools for preventing TB. The treatment for latent TB, much like that for active disease, involves an intense course of antibiotics that doesn't foster patient adherence, especially in people who feel healthy.
The consortium will focus on improving the prevention of TB infection in individuals with latent TB. Ultimately, the efforts of Dorman and her team could vastly improve TB treatment and prevention and alter clinical guidelines for treating TB.
Dorman is driven by her passion to prevent and treat TB.
"I really am motivated to try to help to do a better job of preventing people from getting TB, and, if they do get it, doing a better job at treating them so they survive it."
