Advancing epidemiological methods for surveillance of Mycobacterium tuberculosis infection: new approaches to direct case finding, prevention, and measure vaccine effectiveness

Tuberculosis (TB) is a leading global infectious killer. New TB vaccines, drugs, and diagnostics are now being evaluated in high-burden countries, but methodological advancement of epidemiological methods to understand their impact on recent transmission is urgently needed to capitalise on this investment. In three countries in Africa (Malawi, South Africa, Zambia) that are priority sites for future TB vaccine roll-out, we will discover and validate new epidemiological methods based on clinic convenience serosampling of children for measurement of recent TB transmission. We will use our new epidemiological framework to parameterise Monte Carlo simulation studies to investigate the potential for this clinic-based convenience sampling methodology to be used to rapidly and efficiently measure population-level vaccine effectiveness on recent transmission during scale up. We will support the development of a dynamic cadre of public health scientists and epidemiologists equipped to be leaders in the fight against TB. If the bold aims of this project are successful, we anticipate that the impact on TB could be transformative for efforts to end TB, and for other infections. Our methods will guide better-targeted screening and prevention interventions and discover new methods to evaluate the population impact of new TB vaccines, screening, and preventive interventions.