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Biomarker Analysis for Diagnosing and Treatment Monitoring in Extrapulmonary Tuberculosis Patients in Nairobi, Kenya (BioTube)

7. november 2026 opdateret af: Nobuo Saito, Nagasaki University

Biomarker Analysis for Diagnosing and Treatment Monitoring in Extrapulmonary Tuberculosis Patients, in Nairobi, Kenya

Tuberculosis (TB) remains a global health threat with high incidence, especially in Africa. The proportion of extrapulmonary TB (EPTB) can escalate up to 36% in areas with a high HIV prevalence. Effectively managing and controlling EPTB in high-burden regions, such as Kenya, faces obstacles owing to the limitations of the current diagnostic tools. Traditional methods, such as smear microscopy and culture, often fail to detect EPTB due to the paucibacillary nature of the disease and while newer molecular techniques such as Xpert MTB/RIF have improved the diagnosis of pulmonary TB, they demonstrate reduced sensitivity for EPTB. The inadequacy of these tools results in delayed or missed diagnosis, contributing to higher morbidity and mortality. This underscores the urgent need for more sensitive, non-invasive diagnostic methods that can be applied in resource-limited settings like Kenya. This study aims to establish a biomarker-based diagnostic method for EPTB, using biomarkers such as lipoarabinomannan (LAM), MPT64, and Ag85B to diagnose and to monitor treatment response. Additionally, to clarify the characteristics and causative microorganisms of patients suspected of having TB but yielded negative results. Techniques such as ultrasensitive enzyme-linked immunosorbent assays (ELISA) and urine concentration methods will be employed to improve detection sensitivity. It also seeks to explore the extent of non-tuberculosis mycobacteria (NTM) and fungal infections in patients in patients presenting as presumed TB.

This prospective cohort study will be conducted at Kenyatta National Hospital and Mbagathi County Hospital in Nairobi, enrolling 763 adult patients with presumed extrapulmonary TB (EPTB) and 150 control participants from November 2024 to October 2028 Clinical and demographic data, along with sputum, blood, and urine samples, will be collected at enrolment for microbiological tests and biomarker analysis. The accuracy of biomarkers will be assessed by comparing their sensitivity and specificity against established diagnostic standards. For confirmed EPTB cases (n=50), follow-up samples will be collected during TB treatment to monitor biomarker trends alongside the patient's clinical progress.

This study can enhance EPTB diagnosis by evaluating the diagnostic profile of candidate biomarkers in urine or blood samples. The findings may lead to the development of accurate, non-invasive diagnostic tools suited for resource-limited settings, improving early detection and treatment outcomes. Additionally, by clarifying the epidemiological and microbiological profiles of TB, NTM, and fungal infections, the study could guide more targeted clinical management strategies, ultimately improving patient care in high-burden regions.

Studieoversigt

Status

Rekruttering

Betingelser

Undersøgelsestype

Observationel

Tilmelding (Anslået)

700

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

      • Nairobi, Kenya
        • Rekruttering
        • Kenyatta National Hospital
        • Kontakt:
      • Nairobi, Kenya
        • Rekruttering
        • Mbagathi County Referral Hospital
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

N/A

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Clinically suspected of having TB lymphadenitis, TB pleuritis, and TB meningitis.

  • Clinically suspected TB lymphadenitis: Patients with one or more palpable lymph nodes (>20 mm in diameter) located in the cervical, axillary, or inguinal regions.
  • Clinically suspected TB pleuritis: Patients presenting with respiratory symptoms (e.g., dyspnea, cough, chest pain) along with radiographic evidence of pleural effusion.
  • Clinically suspected TB meningitis: Symptoms and signs of meningitis including one or more of the following, headache, irritability, vomiting, fever, neck stiffness, convulsions, focal neurological deficits, altered consciousness or lethargy.

Beskrivelse

Inclusion Criteria:

  • Age 18 years and above
  • Clinically suspected active EPTB assessed by study clinicians
  • Patients with HIV with and without HIV infection
  • Patients whose samples can be collected from affected sites (such as lymph node aspirations and biopsies, pleural aspirations, and cerebral spinal fluid aspiration according to type of EPTB suspected)
  • Informed consent from patient

Exclusion Criteria:

  • Pregnant women: Due to complexities in follow-ups and obtaining samples
  • Patient with any type of cancer who is given anti-cancer treatment within the last one year or who has undergone surgery for cancer within the last one year
  • Patient who is taking immunosuppressive medications within the last one year: To minimize the impact medication-induced immune responses on TB disease progression and the accuracy of biomarker measurements
  • Patient who has anuria or oliguria and unable to provide 30-50ml of urine
  • Given TB treatment within one year: To avoid confounding effects from recent therapy
  • Patient who is mentally unstable

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: COHORT
  • Tidsperspektiver: PROSPECTIVE

Kohorter og interventioner

Gruppe / kohorte
Extrapulmonary tuberculosis

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Sensitivity and specificity of biomarkers, such as lipoarabinomannan (LAM), MPT64, and antigen 85B (Ag85B) assays, for the diagnosis of extrapulmonary tuberculosis
Tidsramme: From enrollment to the end of treatment at 6 months

Sensitivity and specificity, with 95% confidence intervals, will be estimated separately for each candidate biomarker assay. Biomarker results from specimens collected at enrolment will be evaluated against microbiological and clinical reference standards using the protocol-defined classifications of definite extrapulmonary tuberculosis, probable extrapulmonary tuberculosis, non-tuberculosis, and unclassified disease. Case classification will be performed at 6-8 weeks after enrolment.

From enrollment to the end of treatment at 6 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

8. april 2025

Primær færdiggørelse (Anslået)

31. oktober 2028

Studieafslutning (Anslået)

30. marts 2030

Datoer for studieregistrering

Først indsendt

21. oktober 2026

Først indsendt, der opfyldte QC-kriterier

22. oktober 2026

Først opslået (Faktiske)

28. oktober 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

12. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

7. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • KEMRI/SERU/CRDR/109/5040

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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