30 Dec 2020
Improving the health of people with Tuberculosis in Victoria
Tuberculosis (TB) causes more deaths globally than any other infectious disease. But here in Australia, we tend to think TB is not really a problem. But is that true?
It might perhaps come as a surprise to many that each year there are approximately 450 new diagnoses of TB in Victoria.
“Most of the people I talk to in Australia think that TB isn’t a thing anymore,” says Associate Professor Justin Denholm, Medical Director of the Victorian TB Program at the Doherty Institute.
“That invisibility is testament to the 60 plus years of dedicated and consistent public health work in Australia to bring TB under control.
“But the reality is, 11 million people contracted TB globally last year, and nearly 1.8 million died.
“In a global society there is a lot of movement, so part of our role is in making sure people are aware of some of the risks of TB and identify opportunities to prevent them getting sick.”
The Victorian TB Program is the state wide provider of public health services relating to TB, such as patient management and care, disease surveillance, and working with hospitals and general practitioners to help them support their patients.
“Being a part of the research and collaborative environment at the Doherty Institute over the last five years has placed the Program in a unique position in Australia. Researchers have the ability to apply a range of research approaches to significantly improve health outcomes for people,” says Associate Professor Denholm.
In 2018, the Program was working with a patient who had a form of drug resistant TB and was experiencing a range of side effects to their complicated treatment.
“We were able to sequence the mutation here at the Doherty Institute. Then in collaboration with a PhD student working with us and at the Bio21 Institute, we built a computer model of that mutation and demonstrated that it was resistant to a certain drug – never shown before,” explains Associate Professor Denholm.
"This all happened in real time and the patient was safely cured of her TB.”
The implementation of routine whole genome sequencing has been a game changer.
“We had a husband and wife who had just arrived from a country where TB is a high burden and both received a positive diagnosis,” says Associate Professor Denholm.
“The natural assumption was that one person had contracted it from the other but through sequencing, we found they had two completely different strains that required different management.”
The Program is considered a centre of regional expertise and is involved in building capacity internationally. Locally, they’re also involved in new education development programs to up skill nurses and other healthcare workers with training and operational research
This article was first published in the Celebrating Five Years of the Doherty Institute Impact Report.