Exposed to MDR-TB, what happens next? A multi-national observational cohort e-registry to study natural history and improve outcomes (360G-Wellcome-210830_Z_18_Z)

Multi Drug Resistant Tuberculosis (MDRTB) it is difficult to diagnose and treat. Globally 50% of diagnosed cases do not successfully complete treatment. Currently there is no treatment for MDRTB-exposed contacts (people who have spent > 8 hours/week with an MDRTB patient). Exposed contacts of MDRTB who could develop disease and lead to ongoing transmission need to be identified, diagnosed and treated early. Contact tracing helps us identify people with early TB or asymptomatic latent TB infection (LTBI). Our aim is to improve and harmonise processes used to identify MDRTB contacts who are most likely to be reservoirs of infection. We will recruit longitudinal cohorts in two countries using a mobile application (app) for TB nurses to enable care and follow-up of contacts. The app will populate a registry of contacts to be followed up for two years at six monthly intervals. This will create a data set allowing me to answer questions around the likelihood of MDRTB exposed contacts developing secondary disease and the risk factors involved. A registry automatically generates a list of eligible contacts to receive a preventive treatment once one is available. A second study at one site will explore risk factors associated with progressing to active disease.