Tackling challenges to tuberculosis elimination: Vaccines, drug-resistance, comorbidities

Despite being an ancient disease, tuberculosis causes more deaths than any other infection by a single agent. The current goal by the global public health community is to end tuberculosis by 2035. However, lack of an effective vaccine, emerging drug-resistances to important medicines, and comorbidities and coinfections emerging during antimicrobial treatment hamper elimination of tuberculosis. This thesis aims to tackle these challenges by i) describing the design and evaluation of a novel tuberculosis vaccine candidate that is more effective in protecting against tuberculosis infection in animal models than the currently used BCG vaccine; ii) testing an improved diagnostic algorithm to assess resistance to Ethambutol, a first-line drug; iii) checking the feasibility of glucose testing among difficult-to-reach tuberculosis patients, to check for diabetes; and to elucidate the population structure and biology of Stenotrophomonas maltophilia, an important emerging opportunistic pathogen relevant in the context of tuberculosis.