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In 2022, tuberculosis (TB) remained a significant global health challenge, infecting approximately 10.6 million people, including 1.3 million children. Diagnosing TB in adults often involves sputum samples analyzed in microbiology laboratories. However, children’s TB diagnosis is primarily clinical since they seldom produce sputum, leaving about 60% of cases undiagnosed. This lack of diagnosis is critical as untreated TB can be fatal for one in five children under 14.
The urgent need for new, sensitive, non-invasive, and easy-to-perform diagnostic methods has led to the exploration of innovative solutions. FFP2 masks, known for filtering exhaled air, have shown success in detecting TB genetic material (M. tuberculosis-DNA) in adults. However, similar studies for children were nonexistent until recently.
To address this gap, Lennard Meiwes, a medical student from Lübeck, developed a novel method at the Research Center Borstel. This technique aimed to detect M. tuberculosis DNA from respiratory masks worn by children. Collaborating with clinicians and scientists in Germany and the Republic of Moldova, Meiwes conducted an initial clinical study to test the method’s feasibility.
In the study, children with pulmonary tuberculosis wore three modified FFP2 masks for half an hour each. These masks were equipped with strips of 3D-printed polyvinyl alcohol, purchased by Meiwes on eBay, to capture breath samples. The collected samples were then analyzed using manual and automated polymerase chain reaction (qPCR) and targeted next-generation sequencing to identify bacterial genetic material and antibiotic resistance.
Despite laboratory success in reducing the detection limit to less than four copies of the pathogen’s genetic material, clinical trials revealed that M. tuberculosis DNA was undetectable in any of the 30 masks worn by children for 30 minutes. “Our method showed a low detection limit, but we couldn’t detect the bacteria’s genetic material in clinical use in children. These results suggest that children with pulmonary tuberculosis likely do not produce aerosols capable of transmitting the bacteria,” Meiwes explained. His findings have been published in The Journal of Infectious Diseases.
Building on Meiwes’s groundwork, Dariusz Wölk, a medical student from the University of Hamburg, is now testing the method in adults in the Republic of Moldova. Like Meiwes, Wölk has taken a year off from medical studies to focus on this research. Early results indicate the method’s effectiveness in adults, showing promise for future applications.
The groundbreaking work of Meiwes and his team highlights both the challenges and potential in developing more effective TB diagnostics for children. As research continues, the hope is to improve early detection and treatment, ultimately saving more lives.
More Information: Lennard Meiwes et al., “Whispers in the Wind: Face Mask Sampling for Mycobacterium tuberculosis Detection in Children With Pulmonary Tuberculosis,” The Journal of Infectious Diseases (2024). DOI: 10.1093/infdis/jiae282
Journal Information: Journal of Infectious Diseases
