Swiss TPH is consortium member in the TB-CAPT project (Close the gap, increase Access, Provide adequate Therapy), which will help improve tuberculosis (TB) diagnosis and management at the point of care. A series of clinical trials will generate evidence to inform diagnostic strategies for TB and TB/HIV co-infection, including drug-susceptibility testing. The project is led by the Foundation For Innovative Diagnostics (FIND, www.tb-capt.org)
The introduction of automated real-time PCR-based raised the hope for improved tuberculosis (TB) case-detection and reduced diagnostic delay. Many studies conducted since then have contributed to both an understanding of the test’s limitations and the need for better tests to achieve the post-2015 TB targets of the World Health Organization (WHO). Even more importantly, the studies highlighted the need for optimized implementation strategies for novel tests and improved linkage to treatment. Next generation tests need to be placed at the point-of-care at microscopy centre level, fully integrated in the diagnostic and treatment network, connectivity enabled, more sensitive and able to perform expanded drug susceptibility testing (DST).
TB-CAPT includes a series of clinical trials in Tanzania, Mozambique and South Africa to evaluate the impact of diagnostic interventions on outcomes, including the effects of expanding TB testing strategies to those who are HIV positive. The trials have been designed to take into account local epidemiology, as well as existing infrastructure, and will compare new strategies with current standards of care.
The trials have the aim to provide evidence for most impactful implementation strategies depending on local epidemiology and existing infrastructure, rather than just providing evidence on technology introduction. Data gathered will inform WHO policy on point-of-care testing strategies for TB in broad patient populations, and support planning for potential implementation and scale-up by participating ministries of health. Further, TB-CAPT will build capacity for the implementation of diagnostic trials that will serve in the evaluation of future diagnostic tests. The TB-CAPT project is part of the EDCTP2 programme supported by the European Union.
TB-CAPT is being implemented by a FIND-led consortium that includes: African Society for Laboratory Medicine (ASLM), Ethiopia; Fundacao Manhica, Mozambique; Fundación Privada Instituto de Salud Global Barcelona, Spain; Ifakara Health Institute Trust, Tanzania; Instituto Nacional de Saúde, Mozambique; Ludwig-Maximilians-Universitaet Muenchen, Germany; National Institute for Medical Research – Tanzania, Tanzania; Ospedale San Raffaele, Italy; Swiss Tropical and Public Health Institute, Switzerland; University of Cape Town, South Africa; and Wits Health Consortium, South Africa