The presence of infectious disease has been observed to give rise to distinct patterns of whole-blood gene and protein expression. 
However, using these patterns to derive diagnostic biomarkers capable of distinguishing phenotypically similar diseases remains challenging,
particularly because signatures have to be robust to geographical heterogeneity, to the presence of endemic underlying co-infections and to measurement 
variability from different expression assays.

Whole blood RNA data from HIV infected and uninfected individuals presenting with tuberculosis, from three different sites in Africa were used to elucidate the host transcriptional response to TB and to identify minimal biomarker signatures that discriminate TB from other phenotypes. The signatures we identified had markedly improved  sensitivity and specificity with respect to signatures previously defined on European HIV-ve samples, demonstrating the importance
of developing signatures which are regionally specific.

This work demonstrates the potential for development of host transcriptional and proteomic response signatures for diagnosis and monitoring of  tuberculosis in Papua New Guinea.