2017 - 2022
Cameroon, Ivory Coast, Mozambique, Uganda, Sierra Leone, Zambia and Cambodia
Only 45% of estimated pediatric tuberculosis (TB) cases were notified to WHO in 2016. A majority of the 250,000 pediatric TB deaths occur in undiagnosed children under the age of 5. A majority of children with TB are undiagnosed or unreported and do not receive appropriate treatment.
This is due to the lack of diagnostic capacities for childhood TB in many primary health centers and district hospitals in countries with high TB prevalence. Diagnosis of TB in young children is complicated for several reasons: difficulty in collecting respiratory specimens from children, limited access to good quality X-ray examinations, no rapid, effective, and easy-to-use diagnostic test for TB in children, lack of trained health personnel for TB management, and no systematic screening for TB in the most vulnerable children (children with severe malnutrition, HIV infection, or severe pneumonia).
The TB-Speed project implements research activities aiming at reducing child mortality from TB by assessing innovative and cost-effective TB diagnostic approaches in low-income countries. This research is organized around two major themes
- Decentralization of pediatric TB diagnosis to district hospitals and primary health centers
- Systematic detection of TB in HIV-infected children, children with severe pneumonia, or those suffering from severe malnutrition
This research includes an optimized bacteriological diagnostic approach using a newly developed molecular test (the GeneXpert test), performed on specimens in children that are easier to obtain (stool samples and nasopharyngeal aspirates), the introduction of digitalized chest radiography, and training and support for clinicians in the screening and diagnosis of TB in children.
The project conducted five research studies involving children, it strengthened diagnostic capacity for childhood TB in 16 hospitals, 12 district hospitals, and 48 primary health centers. A total of 7,358 children were included in all the TB-Speed studies. The project also assessed the cost and cost-effectiveness impact of the different interventions evaluated according to the countries' health care systems and epidemiology.
Some preliminary results of the project have already been shared with the scientific community and contributed to revisions of the WHO Technical Guide and Operational Manual for TB published in March 2022.
Its multidisciplinary consortium, coordinated by the University of Bordeaux, brings together researchers, technical experts, health professionals, directors of public health programmes and non-governmental organizations from Europe, Africa and South East Asia.
- French National Research Institute for Sustainable Development (IRD), France
- University of Bordeaux, France
- Makerere University - Johns Hopkins University Research Collaboration (MU-JHU), Uganda
- Institut Pasteur, Cambodge
- ANRS - Programme PAC-CI, Ivory Coast
- National Health Institute, Mozambique
- Solidarité thérapeutique et initiatives pour la santé (SOLTHIS), France/Sierra Leone
- University of Zambia, Zambia
In each country, th project TB-Speed is implemented in collaboration with Ministries of Health, National Tuberculosis Control Programmes (NTCPs), and national hospitals and institutes.
With the support of :
- Olivier Marcy : IRD Senior Researcher/University of Bordeaux/U1219 Bordeaux Population Health Research Center (University of Bordeaux – Inserm)
- Maryline Bonnet : IRD Senior Researcher - UMI 233 TransVIHMI
- Eric Wobudeya: Researcher at Makerere University-Johns Hopkins University Research Collaboration/Consultant Paediatrician and Epidemiologist/Head of the Mulago Paediatric TB Unit in Mulago National Referral Hospital
Official website of the project : https://www.tb-speed.com/