Grant: Doctoral Award - Frederick Banting and Charles Best Canada Graduate Scholarships

Multiple drug resistant TB is increasing worldwide despite gains in overall TB control. TB is a curable disease; however, MDR-TB treatment costs are as much as 100 times greater than those for drug-sensitive TB. Despite greater costs, MDR-TB is associated with higher treatment failure rates and more deaths. WHO has called extensively drug resistant TB (XDR-TB) 'essentially untreatable'. A better understanding of MDR-TB and XDR-TB dynamics is crucial for advancing global TB control efforts, which directly impact Canadian TB control efforts. MDR-TB exists worldwide and XDR-TB has been found in countries including Canada. This project will seek urgent answers needed to cope with the challenge of drug-resistant TB locally and abroad. The proposed study will be undertaken in Lima, Peru, which has one of the highest rates of MDR-TB in the Americas. However, except for a history of previous TB treatment or having been in close contact with someone with MDR-TB, little is known about why rates of MDR-TB in Lima, Peru is as high and what determines who is at risk for developing or acquiring MDR-TB. This project seeks to identify social, behavioral and geographic factors associated with having MDR-TB. Collaborators from McGill University, Montreal, Canada and Cayetano University, Lima, Peru will develop a case-control study to investigate how MDR-TB cases differ from persons with drug sensitive TB and randomly selected community controls who have not developed TB. The characterization of MDR-TB cases in Lima, Peru will highlight is any subgroups of the population are highest risk for drug resistance. The results of this study will greatly contribute to the global understanding of MDR-TB and should lead to improved prevention and control of this deadly disease.