Of all diseases, tuberculosis (TB) represents one of, if not, the greatest health disparity between whites and minorities . For every TB-infected white person in the United States, there are an estimated 9 African- Americans, 8 Latinos, 6 Native Americans, 23 Asians, and 21 Native Hawaiian/Pacific Islanders with this disease . Compounded with this disparity is the prevalence of drug-resistant mutations of TB, which have an associated 1000 polymorphisms that span 36 genes, two promoter regions, and one ribosomal RNA coding region . Current methodologies, available primarily to affluent healthcare communities, utilize microbial cultures, which require sophisticated laboratories and weeks before a result can be determined. Difficulties for minorities in a low socioeconomic class to commute and/or follow up with their physicians can result in a lack of appropriate treatment. A low-cost, simple, and rapid point-of-care (POC) test that detects TB and its resistance to first-line drugs (isoniazid, rifampin, ethambutol,and pyrazinamide) would improve TB diagnostics for these minority communities. However, current technologies lack sensitivity, specificity, and/or multiplexing capacity to achieve this goal. We, therefore, propose to develop a POC device that offers the sensitivity of culture methods, specificity of nucleic acid methods, and a broad coverage of mutations. To accomplish this, we will advance our TruArray platform (hemispherical porous gel drop microarrays) for TB diagnostics using on-chip PCR and our existing MDR-TB PCR-microarray biochips. During Phase 1 we demonstrated feasibility of our sample preparation approach, our PCR-micorarray biochips, and prototype POC instrument. For Phase 2 we propose to expand the coverage of our test to include additional mutations that confer resistance to all first-line drugs, integrate this test onto our POC instrument, and translae this system to Laboratorios Medicos Especializados in Juarez, Mexico.
Of all diseases, Tuberculosis (TB) represents one of, if not, the greatest health disparity between whites and minorities. To be specific, for every TB-infected white person in the United States, there are an estimated 9 African-Americans, 8 Latinos, 6 Native Americans, 23 Asians, and 21 Native Hawaiian/Pacific Islanders with this disease. The proposed project is to develop a point-of-care device for identifying drug-resistant strains of Tuberculosis that can be widely disseminated to minority populations.
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