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Snabb forskning inom diagnostikutveckling för TB Network (R2D2TB Network)

4 november 2026 uppdaterad av: University of California, San Francisco

Rapid Research in Diagnostics Development for TB Network (R2D2 TB Network) Studie

To reduce the burden of TB worldwide through more accurate, faster, simpler, and less expensive diagnosis of TB Every year, more than 3 million people with TB remain undiagnosed and 1 million die. Better diagnostics are essential to reducing the enormous burden of TB worldwide. The Rapid Research in Diagnostics Development for TB Network (R2D2 TB Network) brings together experts in TB care, technology assessment, diagnostics development, laboratory medicine, epidemiology, health economics and mathematical modeling with highly experienced clinical study sites in 10 countries.

Studieöversikt

Detaljerad beskrivning

The Rapid Research in Diagnostics Development for TB Network (R2D2 TB Network) study seeks to identify and rigorously assess promising early stage tuberculosis (TB) triage, diagnostic and drug resistance tests (hereafter referred to as "novel tests") in clinical studies conducted in settings of intended use. Rapid diagnosis, identification of drug resistance and effective treatment are critical for improving patient outcomes and reducing TB transmission. However, analysis of care cascades and prevalence surveys indicate that 40-60% of patients with TB are not initiated on effective treatment.1,2 The different types of tests required to reduce this "diagnostic gap" have been described in the form of target product profiles (TPPs). The highest- priority TPPs are for: 1) a point-of-care, non-sputum biomarker-based test to facilitate rapid TB diagnosis using easily accessible samples (a biomarker-based diagnostic test) and 2) a simple, low-cost test that can be used by front-line health workers to rule-out TB (a triage test). The R2D2 TB Network study will evaluate the sensitivity and specificity of novel triage and diagnostic tests against a reference standard including sputum Xpert® MTB/RIF (Mycobacterium tuberculosis/Rifampin) Ultra and sputum mycobacterial culture. The sensitivity and specificity of rapid drug susceptibility tests (rDST) will be compared against a reference standard including culture-based phenotypic DST and whole genome sequencing (WGS) of mycobacterial DNA. In addition, the usability of novel tests will be assessed through direct observations and surveys of routine health workers.

Studietyp

Interventionell

Inskrivning (Beräknad)

26436

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studera Kontakt Backup

Studieorter

      • Dasmariñas, Filippinerna
        • Rekrytering
        • De La Salle Medical and Health Sciences Institute
        • Kontakt:
      • Vellore, Indien
        • Rekrytering
        • Chitoor (Christian Medical College satellite campus)
        • Kontakt:
      • Vellore, Indien
        • Rekrytering
        • Christian Medical College CMC Pulmonary Outpatient Department
        • Kontakt:
      • Vellore, Indien
      • Cape Town, Sydafrika
        • Rekrytering
        • Brooklyn Chest Hospital
        • Kontakt:
      • Cape Town, Sydafrika
        • Rekrytering
        • Khayelitsha District Health Center
        • Kontakt:
      • Cape Town, Sydafrika
        • Rekrytering
        • Scottsdene primary care clinic
        • Kontakt:
      • Cape Town, Sydafrika
        • Rekrytering
        • Wallacedene primary care clinic
        • Kontakt:
      • Cape Town, Sydafrika
        • Rekrytering
        • Kraaifontein Community Health Clinic
        • Kontakt:
      • Kampala, Uganda
      • Kampala, Uganda
        • Rekrytering
        • Mulago Outpatient Department
        • Kontakt:
      • Hanoi, Vietnam
        • Rekrytering
        • Hanoi Lung Hospital, Outpatient departments
        • Kontakt:
      • Hanoi, Vietnam
        • Rekrytering
        • National Lung Hospital, Outpatient departments
        • Kontakt:
      • Lusaka, Zambia
        • Rekrytering
        • Centre for Infectious Disease Research in Zambia
        • Kontakt:

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

12 år och äldre (Barn, Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Novel TB triage and diagnostic tests:

We will include non-hospitalized adults (age ≥ 12 years) with either 1) cough ≥2 weeks' duration, a commonly accepted criterion for identifying people with presumed pulmonary TB (to facilitate standardization across sites and comparison of test performance across sub-groups or 2) risk factors for which TB screening is recommended (HIV infection, self-reported close contact, history of mining work). People with risk factors will be included if they screen positive for TB based on WHO-recommended screening tools as specified below:

Positive TB screening definitions by risk factor:

  1. PLHIV (Risk Factor), CRP >5 mg/dL OR abnormal CXR (Positive TB screening definition)
  2. Self-reported Close Contact (Risk Factor), abnormal CXR (Positive TB screening definition)
  3. History of mining work (Risk Factor), abnormal CXR (Positive TB screening definition)

We will exclude people who:

  1. completed latent or active TB treatment within the past 12 months (to increase TB prevalence and reduce false-positive results, respectively);
  2. have taken any medication with anti-mycobacterial activity (including fluoroquinolones) for any reason, within 2 weeks of study entry (to reduce false-negatives);
  3. reside >20km from the study site or are unwilling to return for follow-up visits; or
  4. are unwilling to provide informed consent

Novel TB rDST assays:

We will include adults (age ≥12 years) who are positive for TB and RIF resistance according to routine diagnostic testing (based typically on Xpert MTB/RIF, Xpert MTB/RIF Ultra, or Hain MTBDRplus). We will exclude people who:

  1. have negative or contaminated results on all baseline (i.e., enrollment) sputum cultures
  2. are unable to provide at least two sputum specimens of 3 mL each within one day of enrollment
  3. are unable or unwilling to provide informed consent

Assessment of the usability of novel TB tests:

We will include health workers at each clinical site who are 1) aged ≥18 years and 2) involved in routine TB testing (collecting specimens for or performing TB tests). We will exclude staff who are unwilling to provide informed consent.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Diagnostisk
  • Tilldelning: Icke-randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Evaluation of various novel TB triage and diagnostic tests.

For the novel TB triage and diagnostic tests, the investigators will conduct large-scale evaluation of design-locked tests in a cohort of adults with presumed TB, with nested feasibility/pilot studies of early and late prototype tests. The investigators aim to enroll 300-450 participants per year at each of five enrollment sites for evaluation of various novel TB triage and diagnostic tests and 50 health workers to assess test usability.

We will evaluate tests intended to make culture more sensitive, faster, and have less contamination.

We will evaluate new staining techniques or visualization methods to increase the sensitivity of smear microscopy.

We will evaluate semi-automated or automated molecular assays intended for use at near point of care or point of care.

We will evaluate semi-automated or automated molecular assays intended for use at near point of care or point of care.

We will evaluate urine LAM assays incorporating techniques such as analyte concentration, higher sensitivity or specificity antibodies, or enhanced visualization to improve LAM detection.

We will evaluate assays measuring host immune response parameters intended for use at near point of care or point of care.

We will evaluate assays assessing volatile organic compounds or exhaled breath condensate for near point of care of point of care detection of TB.

We will evaluate AI-based algorithms evaluating images (chest x-ray, ultrasound) or sounds (cough sounds, lung sounds) including an Infrasound-to-ultrasound e-stethoscope (Level 42 AI, USA).

We will evaluate assays using phages to lyse mycobacterial cells for detection of DNA or antigens.

Experimentell: Evaluation of novel rDST assays

Clinicians at participating sites will be asked to refer adult patients with rifampin-resistance identified by routine molecular testing. The investigators aim to enroll 100-200 patients per year at each of three enrollment sites for evaluation of novel rDST assays.

We will evaluate semi-automated or automated molecular assays intended for use at near point of care or point of care.

We will evaluate targeted and whole genome sequencing assays.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Sensitivity
Tidsram: 7 months

Number of positive results for a given index test/(Total positive + negative results for a given index test) among patients with TB using the microbiological reference standard

7 months
Specificity
Tidsram: 7 months

Number of negative results for a given index test/(Total positive + negative results for a given index test) among patients without TB using the microbiological reference standard

7 months

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

14 april 2021

Primärt slutförande (Beräknad)

31 maj 2031

Avslutad studie (Beräknad)

31 maj 2031

Studieregistreringsdatum

Först inskickad

7 juni 2021

Först inskickad som uppfyllde QC-kriterierna

7 juni 2021

Första postat (Faktisk)

11 juni 2021

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

9 november 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

4 november 2026

Senast verifierad

1 november 2026

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • U01AI152087 (U.S.S. NIH-anslag/kontrakt)
  • R01AI190419 (U.S.S. NIH-anslag/kontrakt)

Plan för individuella deltagardata (IPD)

Planerar du att dela individuella deltagardata (IPD)?

NEJ

Läkemedels- och apparatinformation, studiedokument

Studerar en amerikansk FDA-reglerad läkemedelsprodukt

Nej

Studerar en amerikansk FDA-reglerad produktprodukt

Ja

produkt tillverkad i och exporterad från U.S.A.

Ja

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

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