Treat TB

Locally relevant operational research is a high priority for national TB programs. The inclusion of 'enabling and promoting research' as one of the components of the expanded Stop TB Strategy has reinforced the vital role of research in successful TB control efforts. Yet many countries have been unable to fully incorporate operational research into program activities due, in part, to limitations in both local capacity and available technical assistance. TREAT TB is a funding mechanism available to USAID missions in high priority countries through which operational research needs may be addressed. The summaries below describe country-based activities undertaken through TREAT TB.

Malawi

What is the prevalence of TB and other serious opportunistic infections in patients with weight loss and fever accessing anti-retroviral therapy in Malawi?

Recent studies have shown that up to 26% of patients die in the first year of antiretroviral treatment (ART), with the majority of deaths coming in the first few months of treatment.  A study supported by USAID in Malawi through TREAT TB assessed the prevalence of TB and other opportunistic infections (OIs) in patients presenting with weight loss and fever and who are enrolled on ART.  The study aimed to examine the association of microbiologically proven TB or other OIs with various demographic or clinical hematological or radiographic findings, and to interpret the associations with regard to the empirical for treatment of TB among several categories of patients, and for further investigation and/or treatment of other OIs.  The study was being carried out in three sites in southern Malawi, with laboratory support provided by the Malawi-Liverpool Welcome Trust Clinical Research Partnership in Blantyre. The study ended in early 2011, and the research team plans to publish the findings in 2012.

Research Period: 2010
Research Partners: Malawi Ministry of Health, Dignitas International, Malawi-Liverpool Welcome Trust Clinical Research Programme, WHO/TDR
Status: Completed

South Africa

The Evolution of Drug Resistant TB in a Community

Drug-resistant TB and MDR-TB are growing threats to public health around the world and particularly in South Africa.  It is estimated that at least 14,000 MDR-TB cases are diagnosed each year in South Africa. Treatment and hospitalization of these patients consumes a major portion of the total TB control budget. A challenge for the South African National Tuberculosis Control Programme (NTCP) is to continue to provide effective care to the growing number of MDR-TB patients without compromising the treatment of sensitive TB cases.  This research project focuses on two local communities.  The research goal is to determine whether repeated cycles of similar treatment of TB are likely to promote the development of further drug resistance in patients.   

Research Period: 2010
Research Partners: Desmond Tutu TB Centre
Status: Ongoing

Drug Resistant TB in Children

Drug-resistant TB is primarily a man-made problem arising due mainly to ineffective, non-completed, or inadequate treatment regimens.  Currently there is no consensus among TB experts on how to manage children with MDR-TB or children who are in close contact with adults who have MDR-TB.  This research aims to examine the management of children exposed to drug-resistant TB, while also assessing the treatment of young people in centralised versus non-centralised settings.

Research Period: 2010-2012
Research Partners: Desmond Tutu TB Centre, Western Cape Provincial Health Department, Médecins Sans Frontières (MSF) – South Africa
Status: Ongoing

Operational Research Assistance Project

This multiple year operational research assistance project aims to build a sustainable focus on and more unified approaches to operational research as an integral component of the National TB Control Programme in South Africa. The project also aims to strengthen the capacity of South African professionals at national, provincial, and local levels to conduct operational research independently. The project incorporates a number of activities including research protocol development workshops, mentoring to refine research protocols, support for implementation of operational research, and support for data analysis, report writing and publication of research findings.

Research Period: 2010-2013
Research Partners: Desmond Tutu TB Centre, Provincial and City Health Departments, Academic Institutions, and the National TB Control Programme
Status: Ongoing