Curbing the spread of tuberculosis
Dr Tamas Barry (MBBCh 2020, PhD Medicine 2022-) is a researcher investigating the detection and management of tuberculosis (TB) in Wales. His PhD was funded by Mary and David Mills, who left gifts to support Cardiff University research and education in their Wills. Mary, who studied Medicine at Cardiff in the 1930s, lost her first husband to TB and decided to leave £200,000 to help improve TB diagnosis and care for future generations.
Tamas’ research is working towards limiting the impact of TB and protecting vulnerable groups who may be at higher risk.
"My journey at Cardiff University started in 2015, when I began my undergraduate degree in medicine. I am delighted to be back and continuing my studies as a PhD student, and my focus is on how we can improve screening and diagnostic tests for TB in Wales.
"While we tend to think of TB as more or less eradicated in the UK, it remains a public health concern, with approximately 80 cases of active TB detected annually in Wales as of 2022. There are many more cases of latent TB however, which is asymptomatic and non-infectious.
"Many people’s immune systems clear TB when they are exposed to the disease, for example by an infected person coughing near them. Some, however, will develop active TB, a serious illness which can affect anywhere in the body, but commonly causes a cough, fevers, and weight loss.
"For others, a latent TB infection can remain dormant in the body and ‘awaken’ at a later stage. For example, an elderly person may have contracted latent TB during their childhood, but this may not become active until decades later.
"Anything that causes the immune system to weaken, such as HIV infection, taking immunosuppressive drugs (like some therapies for rheumatoid arthritis), chemotherapy, or simply getting older can cause latent TB to become active. In the right environment the disease can spread rapidly, leading to a major outbreak such as in Llwynhendy, West Wales in 2010.
Screening high-risk populations
"Identifying and treating latent TB is a crucial part of TB management programmes. Screening in Wales is performed with a blood test, typically on specific groups who are at an increased risk of infection and of developing active disease.
"These groups include people travelling to the UK from countries with a high incidence of TB, such as Ukraine, and those due to start certain medications. These also include people living in deprived communities, where drug and alcohol dependence and homelessness are common.
"Part of my research will look at ten years of test data collected in Wales, helping us to understand where we should be focusing our screenings and how to best use our resources in an increasingly resource-limited environment. In collaboration with Public Health Wales, we would then look to develop national screening guidelines for at-risk groups.
Improving clinical tests
"The remaining part of my research focuses on developing a new diagnostic test for TB using a technique called flow cytometry. Existing blood tests are currently unable to identify between different stages of infection, and these are often also outsourced to England or elsewhere.
"We hope that by analysing the immune responses of patients with TB, we can use flow cytometry to develop a new blood test. This should be quick, cost-effective, and take place in Wales, minimising the environmental impact of transport to laboratories.
"This type of test has the potential to be adopted globally and have profound positive impacts for patients.
A personal legacy
"I’m incredibly grateful that funding for my research comes from a generous gift in a Will. It’s inspiring that Mary studied medicine at Cardiff and following the tragic loss of her late husband Thomas, wanted to make a difference for the future.
"I’m very proud to not only drive forward the way we diagnose and treat TB, but to also honour the legacy of Mary and her work as a doctor."
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