Roadmap for development of disease control strategies for bTB

What are we trying to achieve and why? What is the problem we are trying to solve?

Establish the impact of coinfection with other pathogens and its consequence for disease development and pathogen excretion (pathogenesis) and consequences for diagnosis and implementing/interpreting control interventions.

What are the scientific and technological challenges (knowledge gaps needing to be addressed)?

• Challenging to define pathological or immunological read outs required to test for interactions with coinfections.
• Coinfection data may not be as well recorded or extensive as TB data.
• Epidemiological study design to test for interactions on coinfections is challenging.
• Challenge in having relevant immunology toolbox for various host species.

What approaches could/should be taken to address the research question?

• Establishing the role of co-infections in disease progression.
• Classical epidemiological analyses from field data; investigating the impact of coinfection on, for example, diagnosis, response to vaccination etc.
• Consider experimental coinfection challenge models, in vitro or in vivo.
• Consider investigating timing and order of experimental coinfection studies and read outs.
• Consider disease epidemiological modelling, including parameters estimated from experimental work.
• Coinfections might drive pathogenesis and immune responses in opposing directions and may contribute to unintended consequences.

What else needs to be done before we can solve this need?

Structured surveillance for coinfecting agents.
Immunological toolbox for hosts species.

Existing knowledge including successes and failures