TB-CAPT EXULTANT - HIV
Expanding Xpert Ultra Testing for TB Diagnosis Among HIV-positive Patients Admitted to Hospital in Africa
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
To investigate the effect of an expanded TB screening strategy among HIV-positive patients admitted to hospital (including Ultra on sputum, stool and urine, and AlereLAM on urine, performed regardless of presence of TB symptoms) on the proportion of microbiologically-confirmed TB cases starting treatment within 72 hours of enrolment, compared to Ultra testing (on sputum/any tissue) and AlereLAM (on urine) in only those patients who are symptomatic for TB or fulfilling WHO testing recommendations.
to assess the impact of this screening strategy on 2-month all-cause mortality.
• to assess the feasibility of multiple specimens' collection for TB diagnosis within 72 hours of enrolment.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Morten Ruhwald, MD,PhD
- Phone Number: +41 22 710 05 91
- Email: Morten.Ruhwald@finddx.org
Study Contact Backup
- Name: Adam Penn-Nicholson, PhD
- Phone Number: +41 22 710 05 91
- Email: Adam.Penn-Nicholson@finddx.org
Study Locations
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-
-
Maputo, Mozambique, 1100
- Instituto Nacional de Saúde (INS)
-
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Vila Da Manhiça
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Manhiça, Vila Da Manhiça, Mozambique, 1929
- Centro de Investigação em Saúde de Manhiça-Fundação
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-
-
-
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Bagamoyo, Tanzania, 53502
- Ifakara Health Institute (IHI)
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Mbeya, Tanzania, 2410
- National Institute of Medical Research (NIMR)
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Adults (18 years old and above)
- Confirmed HIV infection by serology (including both antiretroviral (ART)- naïve and experienced)
- Admitted to the hospital (adult medical wards) at the time of enrolment.
Exclusion Criteria:
- Unable to provide informed consent (if no authorized relatives are in the position to provide the consent)
- Living outside the catchment area of the participating hospital(s)
- with plans to migrate outside the catchment area within 2 months after recruitment.
- Currently receiving anti-TB therapy or having received anti TB therapy in the last 6 months prior to enrolment
- Receiving preventive TB treatment in the preceding 6 months
- Patients admitted for traumatic reasons, acute abdomen, delivery (maternal conditions), or for planned/scheduled surgery.
- Referred from other hospital.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: intervention arm
The intervention arm for this trial consists of HIV patients with TB testing performed regardless of presence of TB symptoms. Testing will be done on expectorated sputum, stool and concentrated urine with Ultra, and urine with AlereLAM. To fulfil exploratory objectives, we will also collect and store 2x tongue swabs for molecular TB diagnostic assay (Xpert Ultra and/or LumiraDx) testing, blood for testing with CRP, and urine samples which will be stored for retrospective FujiLAM testing and analysis. |
Molecular TB diagnostic test on urine
Molecular TB diagnostic test on stool
|
|
No Intervention: control arm
The control arm for this trial will consist of patients managed according to the current WHO recommended TB testing practices for HIV positive inpatients (as of Q1 2020). TB testing will be done as follows: Sputum Ultra performed whenever the patient has cough, fever, weight loss over night sweats and/or Ultra performed on any tissue (including lymph nodes) from patients with clinical suspicion of extrapulmonary TB. and/or: Urine Alere TB-LAM performed if patients have signs and symptoms of TB (pulmonary and/or extrapulmonary), or with advanced HIV disease, or who are seriously ill, or else irrespective of signs and symptoms of TB, but combined with a CD4 cell count of less than 200 cells/mm . |
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
proportion of participants diagnosed with microbiologically confirmed TB and started on TB treatment within 72 hours of enrolment
Time Frame: 72 hours after enrolment
|
The proportion of participants diagnosed with microbiologically confirmed TB and started on TB treatment within 72 hours of enrolment, separately for intervention and control arm.
The numerator is the number of participants per study arm who are diagnosed with microbiologically confirmed TB and start on treatment within 72 hours of enrolment.
The denominator is the number of participants enrolled per study arm.
We will compare this indicator between both study arms.
|
72 hours after enrolment
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Eight-week all-cause mortality
Time Frame: 8 weeks after enrolment
|
Eight-week all-cause mortality (main secondary endpoint) among all participants enrolled.
The numerator will be number of deaths during eight weeks after enrolment, the denominator is the number of participants enrolled.
We will compare this indicator between both study arms.
|
8 weeks after enrolment
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The proportion of participants who are diagnosed with TB (irrespective of bacteriological confirmation) and started TB treatment within 72 hours of enrolment.
Time Frame: 72 hours after enrolment
|
The proportion of participants who are diagnosed with TB (irrespective of bacteriological confirmation) and started TB treatment within 72 hours of enrolment.
The numerator is the number of participants diagnosed with TB (with or without bacteriological confirmation) who started treatment within 72 hours of enrolment; the denominator is the number of participants enrolled.
|
72 hours after enrolment
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Alberto García-Basteiro, MD, Barcelona Institute for Global Health
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Blood-Borne Infections
- Urogenital Diseases
- Genital Diseases
- Pathologic Processes
- Immune System Diseases
- Infections
- RNA Virus Infections
- Virus Diseases
- Communicable Diseases
- Sexually Transmitted Diseases, Viral
- Sexually Transmitted Diseases
- Lentivirus Infections
- Retroviridae Infections
- Immunologic Deficiency Syndromes
- Gram-Positive Bacterial Infections
- Bacterial Infections
- Bacterial Infections and Mycoses
- Actinomycetales Infections
- Mycobacterium Infections
- HIV Infections
- Disease
- Tuberculosis
- Coinfection
Other Study ID Numbers
Other Study ID Numbers
- TB043-3/1
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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