Approximately two million people die each year worldwide due to tuberculosis (TB), making it the second greatest cause of mortality among all diseases. It is estimated that one-third of the global population is infected with the TB bacillus. In 2010, 8.8 million cases were reported, and, of these, 1.1 million were co-infected with HIV (WHO 2011, Global Tuberculosis Control). Mycobacterium tuberculosis resistance to existing drugs has become the main threat to TB control. During 2009, 11,438 TB cases were reported. More than 10% of these were detected in Valle del Cauca, a state where drug resistance has been documented and includes the municipality with the highest rate of cases: Buenaventura.

Recognizing the magnitude of the TB program, CIDEIM has been conducting research in this area since 1992, in collaboration with local and national public health authorities, as well as national and international investigators.

Currently, the TB thematic area is focused on understanding  the host-pathogen interaction, the dynamic of TB and resistant TB transmission, and on identifying and characterizing the most prevalent and relevant genotypes in southwestern Colombia. The new knowledge should contribute to improving TB control programs.

Strategic objectives

• To improve diagnostic methods and strategies for TB and resistant TB.
• To optimize TB treatment in southwestern Colombian communities.
• To generate knowledge for the design of TB prevention and control strategies by public health authorities.

Current research and services

• Evaluation of alternative methods for diagnosing TB and detecting resistance.
• Characterization of M. tuberculosis molecular isolates circulating in Valle del Cauca.

Achievements

• We evaluated the fixed-dose combination for TB treatment among patients in Cali.
• We participated in the study of a multi-drug-resistant (MDR) TB foci in Buenaventura. In 1998, 9% of new patients were diagnosed with MDR-TB and 11 circulating isolates belonged to the Beijing family (Laserson K et al. Int J Tuber Lung Dis 2000). In 2001, a 6% prevalence of MDR-TB was found among patients 15 years or older with positive bacilloscopy who had not received treatment previously (Moreira C et al Biomédica 2004). In 2011, the M. tuberculosis genotypes circulating in TB and MDR-TB patients were detected, thus establishing an association between the Beijing genotype and MDR-TB in female patients for the first time in Latin America (Ferro BE et al EID 2011).
• We identified the first cases of XDR-TB in Valle del Cauca and Colombia.