Humans have lived side-by-side with tuberculosis (TB) for thousands of years. It’s an aggressive killer and the leading infectious cause of death in the world . In 2022, the World Health Organization reported that 1.3 million people died from TB, with Southeast Asia and Africa having the largest number of infections.
Although TB treatment has vastly improved since the Stone Age, even after completing months-long antibiotic courses, patients are still at risk of death. Between 30 and 50 percent of TB patients have ongoing lung dysfunction after treatment. Former TB patients are nearly three times more likely to die compared to peers who have never had TB, even after they’ve recovered. For some, that can mean losing more than two decades of life. Research shows that these people are not just dying from lung-related diseases but also cardiovascular disease and cancer.
“We’ve had this disease in the human population since the Neolithic era,” said Sophie Huddart, PhD, an assistant professor in the Department of Epidemiology and Biostatistics and Institute for Global Health Sciences at UCSF. “But it was only in the early aughts that it occurred to us that maybe we should see what’s happening to people when they finish treatment.”
Huddart is among the growing number of researchers hoping to understand why the life expectancy of recovered TB patients gets cut short.
“These people have intensive contact with a health care system and, on average, are young and in the prime of life,” said Huddart. “So, to have people dying, something is quite wrong here.”
Huddart recently received a two-year, $200,000 grant from the American Thoracic Society and the American Lung Association to fund a high-tech, low-cost way of using smartwatches and activity trackers to track patients’ health during and after TB treatment. The devices can keep track of coughing, oxygen saturation, heart rate, sleep patterns and more. Huddart calls these metrics “digital health biomarkers,” which researchers can use to glimpse how TB patients are faring during and after treatment.
For example, Huddart said, a smartwatch can track if a patient’s coughing decreases after starting TB treatment. If it does, that’s a good indication that the treatment is working. If the smartwatch records the same frequency of coughs, however, the patient may need to be switched to different, more effective medications.
These devices will also give Huddart an inside look at how patients fare after they complete TB treatment and which body systems struggle to recover. Hopefully, she said, it will help her and other researchers gain insight into why the repercussions of TB last long after treatment.
Huddart is launching the pilot trial this year in Uganda, which has a high burden of TB. She works closely with collaborators in the country, including Alfred Andama, a principal laboratory technician at Makerere University College of Health Sciences.
She hopes that this trial shows TB patients that researchers are still invested in their well-being, even after they’ve recovered from the disease. “Even if you’re not infectious, you’re still part of our TB community,” she said, “and we are still trying to come up with solutions.”