CNS: TREAT TB seeks answers to key questions in fight against TB

Key questions regarding the new tools and new challenges facing TB control and prevention today are being addressed through an innovative international initiative, TREAT TB. The purpose of TREAT TB, which stands for Technology, Research, Education and Technical Assistance for Tuberculosis, is to conduct field evaluations of new diagnostic tools, clinical trials of priority research questions and operational research benefiting TB control. The initiative is managed by the International Union Against Tuberculosis and Lung Disease (The Union) and funded by the United States Agency for International Development (USAID).

"TREAT TB works to identify and fill gaps in research related to global TB control and at the same time focuses on activities that have the potential to influence policy at global and local levels," said Dr ID Rusen, TREAT TB Project Director for The Union.

Some of the questions currently being addressed by TREAT TB are:

STREAM: Can the treatment regimen for MDR-TB be shortened?

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The length of treatment required to cure multidrug-resistant TB is a major problem for both patients and health systems. In the STREAM study, The Union is collaborating with TREAT TB partner the Medical Research Council (UK) to evaluate a shortened, standardised regimen for MDR-TB. Enrolment for the trial will begin in 2011, and it will eventually involve some 400 patients in 4 countries.

PROVE IT: How much will it cost to roll out a new diagnostic tool?

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To meet the need where it is greatest, new diagnostic tools must be affordable in high-burden, low-income countries. The PROVE IT study is assessing the costs associated with the roll-out of the new diagnostic tool Line Probe Assays. Implementation of PROVE IT (Policy Relevant Outcomes from Validating Evidence on Impact) began this month in South Africa and will begin in Russia and Brazil in May 2011. TREAT TB partners the Desmond Tutu TB Centre in Cape Town; REDE-TB, a Rio de Janeiro-based research organisation; and Northern State Medical University in Russia are implementing the PROVE IT study.

ORAP: How can rural areas find practical solutions to TB control?

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Operational Research is an essential tool for gathering data and finding practical local solutions for issues in TB control. The Operational Research Assistance Project (ORAP) in South Africa has funded 15 research projects based in settings where such research is a relatively new enterprise. All of the projects were determined to be of great importance by the national Department of Health and are funded by the South Africa USAID Mission. Support is provided by from the Desmond Tutu TB Centre and the Free State Province Health Department.

Modelling project: How will new diagnostic tools change the pathways to diagnosis and treatment?

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For stakeholders from policy-makers to materials supply managers, it is essential to be able to envision the impact of new tools and systems. Using data modelling software, TREAT TB partners the Liverpool School of Tropical Medicine (UK) and the National Taiwan University are building and linking operational and transmission models that will provide valuable guidance on the effectiveness of and challenges associated with the adoption of new diagnostic tools in high-burden, low-resource settings.