Tuberculosis is a kind of epidemic now. In many areas of the world including Russia and former USSR countries the two epidemics - TB and HIV are starting to overlap with potentially devastating results. In recent years, emergence and widespread transmission of multidrug-resistant and hypervirulent (MDR-HV) variants of Mycobacterium tuberculosis (MTB) threatens health security of both developed and developing world. It is a challenge not only from a public health point of view but also in the context of global economy.

Two Partner Countries, Bulgaria and Russia, represent a world region with most alarming situation with Multidrug-resistant tuberculosis (MDR-TB).

The proposed project has, in our opinion, a double novelty. First, conceptually, it merges problems of an already recognized emergence of Multidrug-resistant TB with not yet appreciated circulation of the Hypervirulent TB strains, and proposes to consider them as a combined problem of increasing propagation of MDR-HV TB strains. Second, methodologically, this project aims to develop, evaluate and implement a fast, high-throughput and inexpensive methods for detection of MDR-HV TB strains.
The three-step strategy will be based on use of sensitive molecular techniques and will include simultaneous (1) diagnostics of TB (2) detection of drug-resistant, and (3) hypervirulent MTB variants/genotypes. The obtained information will be used for timely prevention of TB via early diagnosis and adequate treatment of TB patients. We cooperate with local and national health authorities and laboratory diagnostic services (“end-users”) in order to implement the proposed strategy into national TB control programs in the participating Partner Countries.

M. tuberculosis strains from Russia, Bulgaria, and Caribbean are being studied by microbiological and genetic methods. Some of these methods are utilized only in one laboratory with DNAs being sent from the other two laboratories; for safety reasons, no live strains will be transported. Study of pathogenic properties of different strains will be done in Russia and Bulgaria.