Context
When TB is active and detectable, it can be treated. Patients may receive 6 to 24 months of treatment, depending of the drug susceptibility of the Mycobacterium tuberculosis strain responsible for the disease.
Latent TB infection (LTBI) is asymptomatic and a cause for growing concern. Up to one third of the world’s population is estimated to have LTBI, and on average, 5 to 10% will develop active TB disease over their lifetime. Because people with LTBI represent a large human reservoir for TB, it poses a major challenge to efforts to end the global TB epidemic. To eliminate TB by 2050 in line with the WHO END TB strategy, programmatic management of individuals with LTBI is necessary.
Objective
The APRECIT* project, launched in 2019, is designed to evaluate different screening strategies and to improve overall programmatic management of latent TB infection and high-risk groups in Madagascar and Cameroon.
Activities
In partnership with the Malagasy and Cameroon National TB Programs, this project involves assessing:
- A community intervention strategy within households of active TB cases for the identification and management of individuals with LTBI and high-risk groups (children under age 5 and HIV-positive individuals), in quantitative terms and from a cost/efficacy perspective;
- Diagnostics with 2 interferon-gamma-release assays (IGRA) compared to the gold-standard tuberculin skin test to identify individuals with LTBI;
- The prognosis value of IGRA to predict progression from LTBI to active TB infection, in terms of sensitivity/specificity and from a cost/efficacy perspective.
In each country, 1,250 household contacts of people with active TB are being recruited for a total of 2,500 direct beneficiaries. Community health agents visit households and perform the LTBI screening tests at home. All voluntary participants are monitored for 24 months.
