Cover photo: A new prison in Paraguay prepares to open. Prisons have an alarming rate of TB, underscoring the urgent need for more resources to combat the disease in these settings. By Jason Andrews.

By Jamie Hansen, Communications Manager

On World Tuberculosis (TB) Day, March 24, we recognize global efforts to combat this deadly disease, which sickens more than 10 million people per year and is one of the world’s foremost infectious killers.  

At Stanford, Dr. Jason Andrews, a Global Health Faculty Fellow and Professor of Medicine, is focused on reducing disparities in tuberculosis treatment and enhancing patient outcomes in resource-limited settings.

Shining a light on TB in prisons

Together with his colleagues, Dr. Andrews published a comprehensive study in The Lancet Public Health in July 2023. This study, the largest of its kind, estimated the incidence of tuberculosis among incarcerated populations globally. Their findings highlight an alarming rate of TB in prisons, with nearly half of the cases undetected – emphasizing an urgent need for increased resources to prevent TB in these surroundings. Read more in this interview.

In October 2023, Dr. Andrews, along with Stanford medical student Aditya Narayan, published in PLOS Medicine, advocating for prioritizing incarcerated individuals for preventive TB treatments. Read more in this Q&A.

Customizing TB treatments to improve patient outcomes

Genetics can influence how individuals react to certain drugs, such as those used in TB treatments. Dr. Andrews and his team are studying how drug dosages can be customized for specific populations to minimize side effects and optimize treatment efficiency.

In a recent study published in the American Journal of Respiratory and Critical Care Medicine, Dr. Andrews’ team developed and validated a tool utilizing pharmacogenomics – precision medicine that considers the patient’s unique genetic makeup – to guide TB drug dosing in South Africa. 

They discovered that over half of the patients receive improper drug dosages based on their metabolic capacities, leading to potential drug toxicity or risk of treatment failure and relapse. Currently, Dr. Andrews and his team are examining the application of pharmacogenomics in guiding TB treatments in Brazil, with support from the National Institutes of Health. 

“The overarching goal of this work is to make optimization of TB treatment possible for all patients,” Dr. Andrews said, adding, “We are eager to share protocols and resources to make these assays available and accessible.”

Anyone interested in collaborating can contact Dr. Andrews at jandr@stanford.edu.