Biology subjects

Mbelele, P. M.

Publications and source records attributed to Mbelele, P. M..

4 recordsLinked to original sources

bioRxiv2026

Serum nutritional-metabolic recovery during tuberculosis treatment across BMI-defined undernutrition strata: A longitudinal proteomic reanalysis

Background Tuberculosis remains the leading cause of death from a single infectious agent, and undernutrition is a major modifiable risk factor. Serum proteomics can capture systemic host recovery during therapy, but whether baseline BMI-defined undernutrition alters this trajectory is unclear. Methods We reanalysed processed longitudinal tandem-mass-tag serum proteomics from 30 adults with pulmonary tuberculosis and durable cure sampled at baseline and weeks 8, 17, 26 and 52. Thirteen participants had baseline BMI <18.5 kg/m2 and 17 had BMI >=18.5 kg/m2. Protein-level analyses evaluated baseline differences and week-specific within-participant change; module and recovery-axis models evaluated BMI-by-time interactions, with random-intercept mixed models added as a repeated-measures sensitivity analysis. Three complementary treatment-responsive modules were integrated into an exploratory, nonredundant 36-protein nutritional-metabolic summary axis. Results The reconstructed dataset contained 1,923 quantified features across 150 participant-visits. Inflammatory/acute-phase and metal-handling/nutritional-immunity module scores declined during follow-up, whereas lipid/apolipoprotein-transport, nutritional-carrier and endocrine-immunometabolic scores increased. In the primary week-specific paired-change analyses, no protein-level between-BMI difference in longitudinal change survived false-discovery-rate correction; no curated-module BMI-by-time interaction survived correction. The 36-protein summary axis increased in both BMI strata from week 17 onward. In a random-intercept model without interaction, the BMI <18.5 kg/m2 stratum had a lower average axis score across visits than the BMI >=18.5 kg/m2 comparison stratum, although the confidence interval included zero (difference -1.34, 95% CI -2.76 to 0.08; p = .064). Categorical and continuous BMI-by-time interaction tests did not detect differential axis trajectories. Conclusions Tuberculosis treatment was accompanied by broad longitudinal remodelling of circulating inflammatory and nutritional-metabolic protein systems. An exploratory 36-protein summary axis increased in both baseline BMI strata, while formal interaction tests did not detect BMI-dependent trajectories and remained too imprecise to establish equivalence. BMI should be regarded as an anthropometric proxy rather than a comprehensive measure of nutritional state. The defined axis provides a framework for prospective validation alongside direct measures of body composition, micronutrients, treatment exposure and clinical outcomes.

bioinformatics↗

bioRxiv2026

Distinct transcriptional remodeling of immune and metabolic pathways in severe undernutrition during latent tuberculosis infection does not consistently predict tuberculosis progression across independent cohorts

Background: Undernutrition increases tuberculosis (TB) risk, but whether severe undernutrition during latent TB infection (LTBI) produces blood transcriptional changes that resemble active disease or identify future TB remains unclear. Methods: We reanalyzed whole-blood RNA sequencing from adults with LTBI in GSE152218, comparing severe undernutrition (BMI <16 kg/m2; n=16) with adequate nutrition (BMI >=18.5 kg/m2; n=11). Genes and Reactome pathways were evaluated. A seven-module summary was compared with active TB among severely undernourished adults and tested prospectively in GSE79362 and GC6-74/GSE94438 after pathway-representation assessment. Results: No genes reached FDR <0.05 in the primary model; two did only in sensitivity analysis. In contrast, 241 Reactome pathways were significant and directionally concordant in both models (NES rho=0.954), including complement/Fc-receptor, B-cell, phospholipid/phagocytosis, neutrophil, vascular, autophagy, and cytokine-signaling pathways. Most changed opposite to the active-TB comparison (178/241; pathway rho=-0.390). The seven-module score was unrelated to baseline progression in GSE79362 (adjusted OR per SD=1.090; P=0.6922). In GC6, four modules met the prespecified representation criterion; their baseline score was inversely associated with progression (adjusted OR per SD=0.711; P=0.0218), but secondary and longitudinal analyses were non-confirmatory. Conclusions: Severe undernutrition during LTBI is associated with reproducible immune- and metabolism-related transcriptional remodeling that differs from active-TB biology and does not consistently identify future TB progression.

molecular biology↗

bioRxiv2020

Deploying a novel tuberculosis molecular bacterial load assay to assess the elimination rate of Mycobacterium tuberculosis in patients with multidrug-resistant tuberculosis in Tanzania

BackgroundRifampin or multidrug-resistant-tuberculosis (RR/MDR-TB) treatment has transitioned to injectable-free regimens. We tested whether M. tuberculosis (Mtb) elimination rates measured by molecular bacterial load assay (TB-MBLA) in sputa correlate with composition of the RR/MDR-TB antibiotic regimen. MethodsSerial sputa were collected from patients with RR/MDR- and drug-sensitive TB at day 0, 3, 7, 14, and then monthly for 4 months of anti-TB treatment. TB-MBLA was used to quantify viable Mtb 16S rRNA in sputum for estimation of colony-forming-unit per mL (eCFU/mL). Mtb elimination rates were compared among regimens using nonlinear-mixed-effects modeling of repeated measures. ResultsAmong 37 patients with a total of 296 serial sputa; 7 patients received rifampin/isoniazid/pyrazinamide/ethambutol (RHZE), 8 an all-oral bedaquiline-based regimen, 9 an injectable and bedaquiline-containing regimen, and 13 an injectable-containing but bedaquiline-free regimen. The overall mean daily Mtb elimination was -0.24 [95% Confidence-Interval (CI); -0.39 to -0.08)] log10 eCFU/mL, and it varied with treatment-regimen (p < 0.001). Compared to the adjusted Mtb elimination of -0.17 (95% CI; -0.23 to -0.12) for the injectable-containing but bedaquiline-free reference regimen, the elimination rates were -0.62 (95% CI; -1.05 to -0.20) log10 eCFU/mL for the injectable and bedaquiline-containing regimen (p = 0.019), -0.35 (95% CI; -0.65 to -0.13) log10 eCFU/mL for the all-oral bedaquiline-based regimen (p = 0.054), and -0.29 (95% CI; -0.78 to +0.22) log10 eCFU/mL for RHZE (p = 0.332) ConclusionTB-MBLA distinguished Mtb elimination rates in sputa from patients receiving different treatment regimens, suggesting a reliable monitoring tool for RR/MDR-TB, that does not require mycobacterial culture.

microbiology↗

bioRxiv2018

Gridlock from Diagnosis to Treatment of Multidrug Resistant Tuberculosis in Tanzania: Patients Perspectives from the Focus Group Discussion

IntroductionMolecular diagnostics have revolutionized the diagnosis of multidrug resistant tuberculosis (MDR-TB). Yet in Tanzania we found delay in diagnosis with more than 70% of MDR-TB patients having history of several previous treatment courses for TB signaling complications of prior missed diagnosis. We aimed to explore patients viewpoints and experiences with personal and socio-behavioral obstacles from MDR-TB diagnosis to treatment in an attempt to understand these prior findings.\n\nMethodsThe study was conducted in December 2016 with MDR-TB patients admitted at Kibongoto Infectious Diseases Hospital. We used semi-structured interviews and focus group discussion to examine patients views and experiences during MDR-TB diagnosis. Groups were sex aggregated to allow free interaction and to gauge gender specific issues in the social and behavioral contexts. The discussion - explored patients delivery factors that were impacting delay from MDR-TB diagnosis to treatment. Iterative data collection and analysis was applied with data, codes and categories being compared and refined.\n\nResultsForty-five MDR-TB patients participated in 6 focus group discussions. Challenges and barriers contributing to the delay from MDR-TB diagnosis to treatment were as follows: 1) The general population had differing understanding of MDR-TB that led to seeking services from traditional healers; 2) Also socio-economic adversity made health-seeking behavior difficult and often unproductive; 3) In the health system, challenges included inadequacy of MDR-TB diagnostic centers, lack of knowledge on behalf of health care providers to consider MDR-TB and order appropriate diagnostics; 4) Insufficiency in the specimen referral system for early diagnosis of MDR-TB. Non-adherence of TB patients to first-line anti-TB drugs prior to MDR-TB diagnosis given the multitude of barriers discussed was coupled with both intentional and unintentional non-adherence of health care providers to international standards of TB care.\n\nConclusionPatient-centered strategies bridging communities and the health system are urgently required for optimum MDR-TB control in Tanzania.

scientific communication and education↗