A new grant from the Bill and Melinda Gates Foundation will allow Paul Drain, a professor in the UW Department of Global Health, to conduct clinical evaluation studies of point-of-care tuberculosis (TB) diagnostic tests. These rapid tests deliver quick results to patients and clinicians in hospital and community clinics. By accelerating the initiation of TB treatment, patients may have better outcomes and will be less likely to transmit TB to others. TB has become the leading infectious cause of mortality in the world, due partly to  poorly performing diagnostic test practices.

“Part of the failure to control TB is due to having inadequate or unavailable diagnostic tests in the countries that need them most,” said Paul Drain, an Assistant Professor in Global Health.

“A better path forward is to identify a biomarker that does not rely on a sputum sample, and can be measured before people develop a cough and become highly contagious to others. Tuberculosis is very difficult to diagnose using the conventional tests. The goal of this project is to develop a better point-of-care test for TB that can be implemented worldwide to address the TB epidemic.”

This new grant is a collaboration between UW and clinical research partners in South Africa, including Umkhuseli Innovation and Research Management (UIRM) and the National Health Laboratory Service (NHLS). Drain’s team will also conduct central research at an on-site laboratory at Edendale Hospital in the KwaZulu-Natal province of South Africa, which has one of the highest rates of TB and HIV in the world. The ability to centralize much of their diagnostic testing in an area with a high volume of TB and TB/HIV infected patients is a major strength of this project.

The World Health Organization established the “End TB Strategy” to significantly reduce new TB cases each year by the year 2035. However, in order to achieve this ambitious goal, better near-patient tests and novel testing strategies are needed for simplified, rapid, and decentralized diagnosis of TB disease.

“This project’s research focuses on further developing and implementing point-of-care tests, which are tests that are meant to be used within the clinics to deliver quick results for both patients and providers,” Drain said. “By using new technologies, we may also be able to take diagnostic tests into the community and identify those infected with TB before they are sick enough to require hospitalization.”

As the Associate Director of the UW Tuberculosis Research and Training Center (part of both the Department of Medicine and Department of Global Health), Drain started working at King Edward Hospital in KwaZulu-Natal in 2010 during his medicine residency.

“While living in Durban a few years later, during my Infectious Diseases fellowship, I established research collaborations to develop a clinical research program for improving diagnostic tests for both TB and HIV,” Drain said. “I continue to see patients in South Africa, while developing new and improved diagnostic tests to eliminate the TB epidemic.”

Part of the current issue involves the difficulty of collecting samples of sputum, a combination of saliva and mucus from the respiratory tract. Not only is sputum difficult to collect, but asking patients who have active TB disease to cough and produce a sputum sample can put health care workers at risk of infection.

In addition to being an Assistant Professor in Global Health, Drain is an Assistant Professor in Medicine (Infectious Diseases), and Adjunct Assistant Professor in Epidemiology. Drain is also a practicing infectious disease physician at Harborview Medical Center and the University of Washington Medical Center in Seattle. His research program focuses on the development, evaluation and implementation of diagnostic testing and clinic-based screening, including novel point-of-care technologies, to improve clinical care and patient-centered outcomes for tuberculosis, HIV, and other infectious and non-communicable diseases in resource-limited settings. This project will allow him to take one of his focus areas and apply it to fields outside of the classroom and hospital.

Read more about Paul Drain's research at UW School of Public Health.