PROVIDED.M. tuberculosis is a highly successful pathogen that infects over eight million people per year and leads toover 2 million deaths. One third of the world's population is believed to be infected with this organism, butonly a small minority of those infected will go on to develop active disease. Although some risk factors fordisease progression have been described, host and microbial mechanisms that lead to increasedsusceptibility are poorly understood. The identification of factors associated with the transmission andprogression of drug sensitive and resistant tuberculosis may provide targets for focused clinical and publichealth interventions. Such interventions will be of particular importance for the control of drug resistanttuberculosis, since current control measures focus on the effective treatment of infectious cases. The longterm goals are to elucidate factors involved in the emergence and transmission of multidrug (MDR) andextensively drug resistant (XDR) tuberculosis and to develop and implement interventions that target thesefactors in order to reduce tuberculosis progression and transmission.
The specific aims of this project are toidentify host, microbial and environmental risk factors for the development of drug sensitive (DS) and MDRtuberculosis and to archive strains characterized on the basis of their epidemiologic and clinical behavior sothat they can be used in basic research on strain diversity and its contribution to MDR. We will also establisha comprehensive database which will allow real-time surveillance and be used for epidemic modeling andindividual prediction models that will assist decision making regarding the treatment of drug resistanttuberculosis.
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