Our researchers have identified six biological markers to help diagnose tuberculosis (TB) faster.

Key facts

• TB is the world's deadliest infectious disease. It kills more than one million people each year.

• TB cases are rising in the UK. Annual cases in England now exceed 5,000.

• Delays in identifying active TB allow infections to spread unchecked and worsen treatment outcomes.

• We have identified six biological markers to help diagnose TB faster. This could pave the way for a simple test to speed up diagnosis.

A deadly disease

TB is a contagious disease that usually affects the lungs. It kills 1.2 million people around the world each year, but a further three million cases go undetected.

Current diagnoses rely on tests that are slow, costly and need trained laboratory staff. They often miss cases of TB due to low sensitivity, particularly in children and people with HIV.

Closing the diagnostic gap

An estimated one-third of the global population carries latent TB. This is a dormant form in which the bacteria lie 'asleep' in the body. It causes no symptoms and often remains undetected for decades.

The challenge is telling active, transmissible TB apart from latent TB, other lung infections, and healthy lungs so the right treatment can be given to the right patient at the right time.

Dr Hannah Schiff led the study, which analysed blood samples from people with transmissible TB.

Using cutting-edge proteomic techniques and deep mathematical analysis, they were able to carry out the most detailed investigation ever undertaken to identify the six markers that separate people with active TB from those with other lung infections or healthy, uninfected lungs.

This could lead to a simple test that detects proteins in the bloodstream whose levels differ between people with TB, healthy individuals, and those with other respiratory illnesses.

The project involved researchers in South Africa, Peru and the UK.

Improving accessibility

This research helps drive improvements to TB testing and treatment around the world, especially in high-risk areas and for people with limited access to healthcare. This is a key priority for the World Health Organisation.

Global uptake of a near-patient blood biomarker-based test like a finger prick test, could offer a more accessible and faster route to diagnosis.

Controlling the global spread of TB is also essential to reducing numbers in the UK, as the majority of cases are imported.

Continuing the mission

Dr Schiff is now investigating whether these findings also apply to people co-infected with HIV, using data from a larger study in South Africa.

She is also starting a new collaboration with researchers in India, the country with the highest TB burden in the world, accounting for over a quarter of all global cases, to test the findings there too.