Cobelens F.G.J.: Epidemiology and control of poverty-related infectious diseases

This group’s work focuses on the epidemiology and control of tuberculosis (TB) in resource-poor settings, in particular TB-HIV co-infection, anti-TB drug resistance, and new diagnostics. Using a combination of epidemiological, operational and evaluation/impact research, as well as cost-effectiveness modelling, we attempt to fill for each of these the knowledge gap between basic research and development of new tools on the one, and successful implementation of these tools on the other hand. This involves establishing the needs and conditions for new interventions (e.g. by studying risk groups, associations with M. tuberculosis genotypes), evaluation of such interventions (e.g. diagnostic studies; clinical and community-randomized trials) and assessment of their impact on TB control, health services and costs. Current projects include (generally done in several countries):
1. TB-HIV: impact of HIV epidemic on TB epidemiology; presumptive TB treatment to reduce early mortality during antiretroviral treatment;
2. TB drug resistance: epidemiology of (multi)drug-resistant TB; relationships between genotype variation and drug resistance; impact of molecular resistance assays on MDR-TB control; new drug regimens for treatment of MDR-TB;
3. New diagnostics: usefulness for TB control of interferon-gamma release assays; cost-effectiveness and impact on TB control of rapid molecular assays; evaluation of screening tools for identifying high-risk patients.