Improving weak links in the diagnosis and treatment of tuberculosis

Morita Saktiawati

    Onderzoeksoutput: Thesis fully internal (DIV)

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    Tuberculosis (TB) is one of the oldest and deadliest infectious diseases in the world. We evaluated the current diagnostic TB service in Yogyakarta using sputum culture and intensified follow-up as additional tools and realized that the current work-up primarily based on clinical evaluation, sputum microscopy and chest X-ray is generally accurate, but slow, and not point-of-care based. We studied a hand-held breath test system (electronic nose or enose) that uses a neuronal network recognising patterns of volatile molecules. This technology (using machine learning, or artificial intelligence) has potential as a point of care test; the diagnostic precision in this study was moderate and needs to be further improved. A systematic review of enose systems showed the great potential of such devices. We evaluated first-line TB drug exposure over time in newly diagnosed patients with pulmonary TB, comparing exposure during fasting and fed condition; we modelled the findings to compute smart time points to reduce the burden of blood draws and measurements for patients and the health system. These studies help to tailor treatment for individual patients as well as to improve drug exposure in general informing future guidelines, and thereby improving outcome for patients. Administering TB drugs through the inhalation route instead of injections may help to improve safety and convenience of patients with drug-resistant TB; we explored the possibility to perform studies for this purpose in the setting of Yogyakarta, Indonesia.
    Originele taal-2English
    KwalificatieDoctor of Philosophy
    Toekennende instantie
    • Rijksuniversiteit Groningen
    Begeleider(s)/adviseur
    • van der Werf, Tjip, Supervisor
    • Stienstra, Ymkje, Supervisor
    • Subronto, Yanri W, Co-supervisor, Externe Persoon
    Datum van toekenning18-sep.-2019
    Plaats van publicatie[Groningen]
    Uitgever
    Gedrukte ISBN's978-94-034-1915-2
    Elektronische ISBN's978-94-034-1914-5
    DOI's
    StatusPublished - 2019

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