A quarter of the world's population are already latently infected with Mycobacterium tuberculosis (MTB). In 2018 the WHO reported 1.1 million children became ill with TB leading to 205,000 child deaths. Accurate diagnosis is critical to deliver effective treatments, limit spread and support global eradication. There are several TB diagnostic test types - radiographic methods, culture methods, nucleic acid testing, phage assay, cytokine detection test, detection of drug resistance, and Mantoux test. Culture methods remains the gold standard for confirmation of diagnosis and determination of full antibiotic resistance patterns. Unfortunately, in children, 40% of lung TB cases have such low MTB numbers present that culture confirmation is never achieved. Improved culture diagnostic tests are urgently needed. Tika is developing a game changing TB diagnostic culture enhancement kit that uniquely increases the capability of Mycobacterium tuberculosis (MTB) to grow, be detected and typed for antibiotic resistance in conventional media. The kit also offers a novel method for sample preparation from faeces that will transform sample collection from children, enabling much higher detection rates without the distress of current techniques. Nothing like this currently exists in the market. WHO estimates 60 million TB tests including 3-4 million MTB culture tests are performed annually. Culture based tests lead the TB diagnostics market and this is likely to continue on account of the ability to accurately diagnose and confirm active tuberculosis. (Transparency Market Research). The market segment for MTB culture is $600 million and estimated to grow by 4% CAGR over the next 4 years. WHO is applying pressure on the market through their global "End TB" strategy. Tika has a world leading team of TB experts developing the products, with a clear roadmap to take them to market. The outputs of this project will guide product development, support further development of the business plan / routes to market, and underpin the raising funds to finance the development. The project provides excellent value for money, both economically and for patients.

Bovine tuberculosis (bTB) caused by Mycobacterium bovis is the most pressing animal health problem in the UK. 8.4 million tests for bTB were carried out in the UK leading to slaughter of 32,000 animals. Unfortunately the current diagnosis is reliant on culture of a woefully slow growing organism in conventional media that has not been improved upon for more than 50 years. Our new supplements have excellent potential to significantly reduce the time to diagnosis, massively increase effectiveness of herd screening and positively influence eradication and control programmes for bTB in the UK. We have previously shown that our approach can halve the time for growth of Mycobacterium tuberculosis from human samples. We now wish to adapt and optimise our supplement for bTB and have already preliminary data to show that this will be possible. The project proposes to extensively screen our innovative (and patented) bank of supplements to maximize enhanced growth of bTB in laboratory cultures. We propose in collaboration with AHVLA, to test clinical and environmental samples from cattle and badgers using our supplements and compare against current methods. We will then seek to market this product worldwide.