Intensified tuberculosis case finding and rapid detection of drug resistant disease in patients accessing antiretroviral treatment in South Africa. (360G-Wellcome-088590_Z_09_Z)

This research will be conducted within a well characterised ART cohort in a township in Cape Town. Eligible patients (n=600) without a current TB diagnosis will be screened for TB at enrolment and again after 4 months of ART. On each occasion, two sputum samples from each patient will be subjected to fluorescence microscopy and automated liquid culture. Culture of Mycobacterium tuberculosis (MTB) will be used as the gold-standard for TB diagnosis and isolates will undergo culture-based drug susc eptibility testing. All sputum samples will also be tested with two rapid nucleic acid amplification tests (NAATs) - MTBDRplus and Xpert MTB assays. These are able to detect MTB complex and resistance mutations to rifampicin +/- isoniazid. The sensitivity, specificity, and predictive values of these tests for TB will be determined. The impact of the NAATs on the mean time to TB diagnosis and to detection of drug resistance will be determined. The diagnostic yield of screening for TB after 4 months ART in addition to screening at programme entry will also be determined. The cost-effectiveness of different strategies to screen for TB and TB drug resistance will be formally evaluated.

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Grant Details

Amount Awarded 890484
Applicant Surname Lawn
Approval Committee Immunology and Infectious Disease Funding Committee
Award Date 2009-04-30T00:00:00+00:00
Financial Year 2008/09
Grant Programme: Title University Award
Internal ID 088590/Z/09/Z
Lead Applicant Dr Stephen Lawn
Other Applicant(s) Prof Kenneth Freedberg, Prof Mark Nicol, Prof Robert Wilkinson, Prof Robin Wood
Partnership Value 890484
Planned Dates: End Date 2014-11-30T00:00:00+00:00
Planned Dates: Start Date 2009-06-01T00:00:00+00:00
Recipient Org: Country United Kingdom
Region Greater London