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Kulindana: Expanding Access and Impact of Tuberculosis Preventative Therapy: Community-friendly Delivery and Monitoring of TPT to Improve Uptake and Reduce TB Transmission

29. maj 2026 opdateret af: Adrienne E Shapiro, University of Washington

The goal of this clinical trial is to learn if differentiated service delivery (DSD) of TB preventive therapy (TPT) improves uptake and completion of TPT in two populations: household contacts (HHC) of index TB patients and people living with HIV (PWH). The main questions it aims to answer are:

  • Is community-based and multi-month dispensing of short-course TPT with minimal clinic and laboratory monitoring associated with higher rates of initiation and completion of TPT, compared to standard of care, in both HHC and PWH?
  • Does community-based and DSD TPT reduce household and community TB transmission?

Researchers will compare DSD TPT delivery to standard of care (SoC) to see if DSD TPT delivery has an effect on TPT uptake and completion.

Participants will:

  • Be assessed for TPT eligibility through either DSD TPT service delivery of SoC including differentiated TB screening procedures.
  • If eligible, receive DSD TPT service delivery or SoC TPT service delivery.
  • Over 12 weeks receive either DSD or SoC TPT adherence assessment and follow-up.
  • Have TPT completion assessed at 12 weeks following enrolment.
  • A subset of participants will be assess for TB incidence at 9 months following enrolment.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

We will conduct a two-arm, non-blinded, randomized controlled trial (RCT) comparing differentiated TPT delivery to standard of care (SOC) clinic-based TPT. Our central hypothesis is that decentralized, differentiated-service delivery approaches to TPT will improve TPT uptake and completion in Kenya. This study will be conducted in seven HIV clinics in Kisumu County, a high HIV/TB burden region in western Kenya. This study has two populations:

(A) Household contacts (HHC) of Index TB patients (Index patients: any age, diagnosed with pulmonary TB (or any TB if <18 years), who live with at least one other person not currently taking TB treatment). The TB index patients and household contacts include children.

(B) People living with HIV (PWH), aged 15+ who are eligible for TPT per Kenyan guidelines.

The primary outcome, 3 months after enrollment, is completion of a course of TPT, defined as taking 11 weeks of TPT within 16 weeks.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

1500

Fase

  • Ikke anvendelig

Kontakter og lokationer

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

Studiekontakt

  • Navn: Gillian O'Bryan
  • Telefonnummer: 240-444-0098
  • E-mail: gilliano@uw.edu

Undersøgelse Kontakt Backup

Studiesteder

  • Kenya
      • Kisumu, Kenya
        • Centre for Family Health Research and Development (CEFERD) located at Jaramogi Oginga Odinga Teaching and 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

  • Barn
  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Household contacts (HHC) are eligible for enrolment if they share a residential dwelling with an index TB patient and can provide informed consent (or parental consent, with assent if appropriate).
  • People living with HIV (PWH) are eligible for enrolment if they are adults aged 15 and over, are eligible for TPT according to Kenyan National Guidelines, and can provide informed consent.

Exclusion Criteria:

  • HHC will be excluded if they plan on permanently relocating from the area within the next three months, are not willing to receive TPT screening and initiation at home, or are enrolled in any other investigational/interventional HIV or TB study.
  • PWH will be excluded if they plan on permanently relocated from the area within the next three months, have contraindications for TPT according to the Kenyan National Guidelines, or are enrolled in any other investigational/interventional HIV or TB study.

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Andet
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Differentiated service delivery (DSD) of TPT
In the household contact (HHC) population DSD TPT will be delivered at home in a single dispense of a full course of TPT; in the people living with HIV (PWH) population DSD TPT will be delivered at the clinic in a single dispense of a full course of TPT.
Andet: Differentiated service delivery (DSD) of TB preventive therapy (TPT)
TPT is normally provided at clinics with monthly visits for refills, but the full course of TPT can also be provided all at once through differentiated service delivery (DSD) of TPT. By doing the Kulindana study, we hope to learn which way of delivering TPT to clients (through usual clinic practice, or all at once) is best for helping people finish their full course of TPT.
Ingen indgriben: Clinic-based standard of care
Both the household contact (HHC) population and the people living with HIV (PWH) population have TPT dispensed at the clinic according to standard practice, typically one month at a time.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
TB preventive therapy completion
Tidsramme: 16 weeks
Proportion of participants completing 11 out of 12 weeks of TPT within 16 weeks
16 weeks

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
IGRA conversion
Tidsramme: 9 months
Proportion of child household contacts (age <15 years) who convert their IGRA result from negative to positive.
9 months

Samarbejdspartnere og efterforskere

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

Sponsor

University of Washington

Samarbejdspartnere

National Institute of Allergy and Infectious Diseases (NIAID)

Efterforskere

  • Ledende efterforsker: Adrienne Shapiro, MD, PhD, University of Washington

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 (Anslået)

1. juni 2026

Primær færdiggørelse (Anslået)

1. juli 2030

Studieafslutning (Anslået)

1. juli 2031

Datoer for studieregistrering

Først indsendt

29. maj 2026

Først indsendt, der opfyldte QC-kriterier

29. maj 2026

Først opslået (Faktiske)

4. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

4. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

29. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • STUDY00024388
  • R01AI183979-01A1 (U.S. NIH-bevilling/kontrakt)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

A limited de-identified clinical dataset will be deposited in a public repository by the end of the study award period.

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL
  • SAP

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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