Tuberculous Meningitis Examined in PhD Research
Post-doctoral Research Fellow in the Discipline of Public Health Medicine, Dr Ikanyeng Dolly Seipone of Botswana, graduated from UKZN with a PhD in Virology.
Her research investigated HIV replication characteristics in the cerebrospinal fluid versus blood of individuals with meningitis, including tuberculous meningitis (TBM), and explored immunological biomarkers for the disease.
‘The Southern Africa region has the highest burden of HIV that is further exacerbated by co-infection with TB, hence my interest in HIV/TB co-infection research,’ said Seipone.
‘I personally believe we cannot win the battle against AIDS if we do not also fight TB, since TB is the leading cause of morbidity and mortality in HIV-infected individuals in Africa. Tuberculous meningitis is a common complication in HIV infected people and a diagnosis of TBM still poses a major problem. Data is particularly lacking on HIV-1 subtype C that dominate the sub-Saharan region, and concomitant TB infection of the Central Nervous System (CNS).’
Her PhD study aimed to provide aid in enhancing knowledge on HIV-1 subtype C pathogenesis in tuberculous meningitis co-infection. This led to her pursuing her PhD project on HIV/TB co-infection in the CNS in the HIV Pathogenesis Programme (HPP). Seipone says she was blessed to have met one of the leading international scientists in HIV/AIDS research Professor Thumbi Ndung’u who became her supervisor and mentor for her PhD.
Seipone says that there is a knowledge gap on the HIV subtype C which predominates in sub-Saharan Africa. The impact of tuberculosis in the central nervous system on HIV replication dynamics and evolution are unknown and effective diagnosis of TBM still remains a major problem in developing countries.
On analysis, the study found that tuberculous meningitis was associated with high cerebrospinal fluid viral load and there was evidence of distinct viral strains in the cerebrospinal fluid compared to blood in some patients. The study data suggest that TB co-infection of the CNS is associated with enhanced HIV-1 viral replication and higher HIV-1 quasispecies diversity. Markers that may distinguish tuberculous meningitis from other meningitides were identified and may provide a foundation on biomarkers that can be investigated as possible diagnosis tools for TBM.
‘This study has improved our understanding and has enhanced our knowledge of HIV/TB co-infection of the central nervous system and forms a basis for further research on pathogenesis and diagnosis,’ said Seipone. ‘It offers significant insight on Subtype C HIV-1 evolution and adaptation to the CNS during TB co-infection and might be valuable in the prevention of HIV-neurological disorders and thus managing HIV/TB co-infection. Data from this study has been presented in both local and international conferences and work is in progress for publication of two articles, one in the Journal of Acquired Immune Deficiency Syndromes and the other in the Journal of Virology.
‘I am very humbled and ecstatic. It is still sinking in that I now sit amongst the few African women under 40 with a PhD in Science. I firmly believe we are blessed in order to bless others and therefore aspire to inspire a girl child and make her believe she can achieve anything she wants.’
Seipone says she is in the process of establishing a mentorship programme and has received a number of young aspiring professionals requesting her to mentor them. The driven young doctor is also in the process of registering a woman in science organisation in Botswana to support women in science in her country.
Seipone hopes to one day be a health policy maker at a global level and a leading medical research scientist in Africa. ‘I am passionate about health issues and making a difference.’
Seipone grew up in the village of Kang in the southern part of Botswana. She lost her mother at a very young age and was raised by her father who ensured she received a good education.
‘My ideal world is where people live equal lives and have equal opportunities. This is the same passion that drew me to the post-doctoral project that I am about to embark on which is based on improving the health conditions of refugees and combating diseases of poverty amongst this population and volunteering with organisations such as the Cancer Association of South Africa (CANSA).’