Dr. Stephen Lawn
South Africa lies at the epicentre of the world's tuberculosis and HIV epidemics. Fuelled by HIV, TB notification rates in areas around Cape Town are among the highest in the world.
We are actively engaged in research at laboratory, clinical and public health levels to increase our understanding of this epidemic and to find solutions.
In 2005, Dr. Stephen Lawn joined the DTHF from the London School of Hygiene and Tropical Medicine with funding from the Wellcome Trust. His work addresses key issues related to the extremely high burden of TB within antiretroviral treatment (ART) clinics in Cape Town and is based at the Gugulethu ART clinic.
This work aims to:
- Document the burden and risk factors for TB and the impact of ART on TB incidence.
- Explore the underlying mechanisms for the high rate of TB during ART, including immune reconstitution disease during early ART and incomplete immune recovery during long-term ART.
- Determine the impact of TB within the programme on mortality and outcomes of ART.
- Examine strategies to improve diagnosis of TB at programme entry.
The laboratory component of this work is being conducted at the Institute of Infectious Disease and Molecular Medicine.
The International Union Against Tuberculosis and Lung Disease (IUATLD) acknowledged the contribution of Dr. Lawn and his colleagues at the DTHC with the Annual Scientific Award presented in Paris, October 2006.
The DTHC is also conducting a collaborative study in conjunction with the thoracic surgery and histology departments of the University of Cape Town and the Public Health Research Institute, New Jersey, USA. This study is investigating the host response to tuberculosis by carefully mapping out cellular responses in surgically removed, TB-infected human lungs.
Studies currently being carried out in Masiphumelele give insights into TB/HIV interaction at community level. Cross-sectional prevalence studies have recently been completed; more than 10 years of notification data have been collated and molecular fingerprinting of all TB sputum strains collected will give a comprehensive picture to understand patterns of transmission in the HIV infected and uninfected populations; the reservoirs of undiagnosed TB and other aspects of the co-infections at community level.
