Today is World Tuberculosis Day, held every year on March 24 to commemorate  the date in 1882 when Dr. Robert Koch announced his discovery of Mycobacterium tuberculosis, the bacillus that causes tuberculosis (TB).

Dr. van der Heijden reviewing clinical records at Brooklyn Chest Hospital in Cape Town, South Africa.

One of our former VUMC Faculty Research Scholars, who has since received a K08 award from NIH, studies the epidemiology of tuberculosis and drug resistance in TB treatment.  Yuri van der Heijden, MD, MPH, agreed to tell us a little about his research and give his best advice to folks working toward that career development award.

What are you studying and what are you hoping to find?

My main project focuses on the acquisition of resistance to drugs used to treat tuberculosis. The traditional thinking has been that interruptions in tuberculosis treatment – which usually occur when patients do not take their medications – explain why patients develop resistance to tuberculosis medications. More recently, some studies have shown that even patients who take their medications consistently sometimes develop drug resistance. In my study, we are trying to assess how big of a problem this is in the Western Cape Province of South Africa among patients who already have resistance to the primary two drugs used to treat tuberculosis. Then we are testing tuberculosis isolates and capturing clinical data for patients who acquired further drug resistance to understand the clinical and molecular epidemiology of this problem. We hope to identify risk factors for the development of further drug resistance that can guide treatment decisions in order to prevent the development of drug resistance in patients and preserve important drugs for tuberculosis treatment.

Why does your project interest you?

On a recent trip to South Africa, I met an 18-year-old man at a Médecins Sans Frontières’ tuberculosis treatment center who was struggling to accept what he had been told a few weeks prior – that he had incurable extensively drug-resistant tuberculosis, and that he was going to die from this disease. The sad truth is that his story is not unique. It is scandalous that we have a cure for tuberculosis, yet 1.8 million people still died from it in 2015. Similarly, it is alarming that we now have substantial numbers of patients who do not have any treatment options remaining because they have developed resistance to all available drugs. My project is but one small piece of an enormously complex puzzle that will hopefully allow us to identify ways to prevent the progression to incurable disease.

View from the Brooklyn Chest Hospital in Cape Town.

What’s been the most fun experience you’ve had doing your work?

My family and I moved to South Africa for almost a year so that I could work on my main research project. I had the opportunity to work closely with my South African mentors at Stellenbosch University and University of Cape Town, all of whom are world-renowned experts in their fields. The time spent there was invaluable for my research and a treasured time together with my family.

How did you survive the grant-writing process?

Wow, the grant writing process for the career development award was eye-opening. There was a lot of trial-and-error in the writing process. Ultimately, my collaborators and mentors were extremely helpful, and I was grateful for the many resources at Vanderbilt that helped get me through the process – particularly the bank of previously successful grant applications and several VICTR Studios for critical feedback.

What’s your best advice for researchers coming up behind you?

I cannot emphasize enough the importance of strong mentorship and sound guidance, which can come through a main scientific mentor, but also through friendships with colleagues who are ahead of you in this process and a mentorship committee focused on your career trajectory. I would also highly recommend familiarizing yourself with the many outstanding resources available to you at Vanderbilt, ranging from relevant lectures hosted by the Elliott Newman Society to biostatistics clinics and access to specialized research cores, and most importantly the people who work here. For grant writing, especially the first one, I recommend starting early and making sure you familiarize yourself with all the necessary components far in advance. I wish I had taken advantage of a grant pacing workshop when crafting my career development award application. [Editor’s note: our grant pacing workshop leader is currently blogging a digital version of a grant pacing workshop. Start here to get the goods.]

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1 Comment
Sk8 L8 says:

TB’s a bastard. Keep up the good fight.

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