The Union has launched a project to evaluate the effectiveness of a new strategy to find more people with undiagnosed tuberculosis (TB) in Bangui, Central African Republic.
For the first time in Francophone Africa, The Union and the Central African Republic National TB Programme (NTP) are assessing whether it is possible and valuable to investigate the household and close contacts of people with any form of TB (i.e. bacteriologically confirmed pulmonary TB, clinically diagnosed pulmonary TB and extrapulmonary TB).
Globally in 2023, an estimated 10.8 million people fell ill with TB worldwide, yet only 8.2 million people were newly diagnosed with TB. The World Health Organization (WHO) estimate that approximately 2.7 million people were not diagnosed with the disease, or not officially reported to national authorities in 2023.
Dr Kobto Ghislain Koura, Director of TB at The Union, explained: “The overall objective of the ISco_TB Project is to identify activities and tools to strengthen, measure and standardise contact investigation activities for people with all forms of TB detected in Central African Republic.
“By proactively testing and treating household contacts, we can break the chain of TB transmission and enhance health outcomes for entire families.”
Although this strategy, known as contact investigation, has been recommended by the WHO for many years, it was very poorly implemented and not documented in low- and middle-income countries.
From 2015 to 2019, The Union implemented operational research in four countries and demonstrated that the strategy could be integrated into the routine activities of the NTPs. However, this and many other research studies only focused on investigating the contacts of people with bacteriologically confirmed pulmonary TB.
The ISco_TB project launched in February and aims to recruit over 4,000 people who are in contact with some with any form of TB.
Kobto added: “It is great to work in partnership with our NTP colleagues on this project, as we will be able to get a much better understanding of how beneficial it would be to integrate the strategy into a real-world setting.”
The project team will also evaluate the performance of a new WHO-recommended algorithms for the diagnostic approach of TB, particularly in children under 10 years of age, to determine whether there should be wider uptake of the algorithms.
The project is funded by Agence Française de Développement.