Urine protein biomarkers for tuberculosis diagnosis in children
BACKGROUND: Tuberculosis (TB) in children is very difficult to confirm because of its low bacterial burden. As a result, the diagnosis of TB is delayed or missed in many children, and TB may be incorrectly diagnosed in children with similar symptoms who do not have TB.
GAP: The lack of a sensitive and specific test for TB in children that can be performed in resource-limited settings, i.e. at low cost and with little or no laboratory infrastructure, is a major gap in our ability to diagnose and treat children with TB.
HYPOTHESIS: The quantity of specific host proteins in urine is different for children with TB compared to symptomatic control children who do not have TB. These differences in host proteins in urine can be used to develop predictive models to differentiate children with TB from children with similar symptoms who do not have TB.
METHODS: We will perform a case control study for urine protein biomarker discovery and initial validation. We will quantify the abundance of individual proteins in the urine from children with TB and from symptomatic control children in Kenya, Peru and South Africa, followed by statistical analysis to identify proteins that are present in different amounts in the urine of children with TB compared to controls.
RESULTS: We have identified several proteins that are moderately predictive of TB in children compared to controls (AUROC ~0.75). Ongoing analysis seeks to identify additional proteins andcombinations of proteins that will be better predictors of TB status.
IMPACT: The goal of this study is to identify urine protein biomarkers for TB in children, which could lead to the development of simpler and more accurate tests to diagnose TB in children. Improved diagnosis will lead to more appropriate treatment and better outcomes for children with TB.