Characteristics and Prevalence of Tuberculosis and HIV in Masiphumelele Township, Cape Town, South Africa

NCT ID: NCT00346476

Last Updated: 2011-02-11

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

1250 participants

Study Classification

OBSERVATIONAL

Study Start Date

2006-04-30

Study Completion Date

2010-12-31

Brief Summary

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The purpose of this study is to determine the number of people infected with tuberculosis (TB) in the Masiphumelele Township of Cape Town, South Africa, a community with high rates of TB and HIV. This study will also examine the genetics of TB and the relationships among active TB infection, new HIV infections, and HIV disease progression.

Detailed Description

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TB is the most common opportunistic infection and the single most common cause of death in HIV infected people in Africa today. Latent TB infection has been known to revert to active TB following new infection in HIV infected people; also, TB has been shown to accelerate the progression of HIV disease. These epidemiologic relationships between TB and HIV and the high prevalence of these diseases in sub-Saharan Africa make studying TB and HIV infected populations in this region of the world important. The Masiphumelele Township of Cape Town, South Africa, with its high rates of TB and HIV, is representative of many poor communities in Africa. The purpose of this study is to observe people from the Masiphumelele Township over a 5-year period to assess the prevalence of TB and HIV infections in a random sample of people and the clinical and genetic characteristics of active TB infection.

This study has two parts: a random cross-sectional survey and a clinical and genetic assessment of TB patients. Participants in the random survey will only be involved with the study for a maximum of 2 days. The purpose of the first part of the study is to compare the prevalence of active TB and the prevalence of HIV infection in a random sample of people from the Masiphumelele Township. In this part of the study, children and adults will be randomly selected from the township population to determine the prevalence of active TB and the prevalence of HIV infection in this group of people. Fieldworkers will identify eligible participants in the township and will ask them to visit the clinic that day or the next. At the clinic, participants will be asked to complete a demographics and TB history questionnaire and provide a saliva sample for anonymous HIV testing. A sputum sample will be collected from each participant with a nebulizer; each participant will also be given a sputum sample bottle and will be asked to collect an early morning sputum sample on the next day that will be returned to the clinic.

The second part of the study will enroll TB patients. Participants in this part of this study will be followed for the course of their TB treatment for at least 6 months. The purpose of the second part of the study is to assess changes through time of the clustering and transmission of TB among HIV infected and uninfected people in the Masiphumelele Township. This assessment will include examining the diversity of TB strains in this population and determining the relationship between recurrent cases of TB and HIV infection. All sputum samples indicating TB infections that were previously collected from participants will undergo genetic testing by restriction fragment length polymorphism (RFLP) analysis. Participants will be asked to complete a demographics and TB history questionnaire and provide a saliva sample for anonymous HIV testing. Participants will also be interviewed about treatment they have received for TB, their responses to this treatment, and whether they are currently on highly active antiretroviral therapy (HAART) for the treatment of HIV infection.

Participants who are found to be infected with TB during the first part of the study will be offered TB treatment through the clinic and will be invited to participate in the second part of this study. Participants who are found to be infected with HIV during the study will be referred to further treatment and evaluation.

Conditions

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HIV Infections Tuberculosis

Study Design

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Observational Model Type

ECOLOGIC_OR_COMMUNITY

Study Time Perspective

PROSPECTIVE

Study Groups

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Participants

Individuals in the Masiphumelele Township of Cape Town, South Africa, who have been potentially exposed to TB and/or HIV

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Willing to comply with study requirements
* Parent or guardian willing to provide informed consent, if applicable


* Live in Masiphumelele Township, Cape Town, South Africa for at least 1 week


* Live in Masiphumelele Township, Cape Town, South Africa
* Registered TB patient at the study site

Exclusion Criteria

* Currently incarcerated


* No Mycobacterium tuberculosis specimen obtained from the participant for genetic analysis
Minimum Eligible Age

15 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute of Allergy and Infectious Diseases (NIAID)

NIH

Sponsor Role collaborator

Comprehensive International Program of Research on AIDS

OTHER

Sponsor Role collaborator

CIPRA SA

NETWORK

Sponsor Role lead

Responsible Party

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CIPRA SA

Principal Investigators

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Linda Gail Bekker, MBChB, FCP, PhD

Role: STUDY_CHAIR

Department of Medicine, University of Cape Town

James McIntyre, MBChB, MRCOG

Role: PRINCIPAL_INVESTIGATOR

University of the Witwatersrand, Perinatal HIV Research Unit, Chris Hani Baragwanath Hospital

Locations

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Desmond Tutu HIV Centre Department of Medicine

Cape Town, Western Cape, South Africa

Site Status

Desmond Tutu HIV Centre Department of Medicine

Cape Town, , South Africa

Site Status

Countries

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South Africa

References

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Aaron L, Saadoun D, Calatroni I, Launay O, Memain N, Vincent V, Marchal G, Dupont B, Bouchaud O, Valeyre D, Lortholary O. Tuberculosis in HIV-infected patients: a comprehensive review. Clin Microbiol Infect. 2004 May;10(5):388-98. doi: 10.1111/j.1469-0691.2004.00758.x.

Reference Type BACKGROUND
PMID: 15113314 (View on PubMed)

Badri M, Ehrlich R, Wood R, Pulerwitz T, Maartens G. Association between tuberculosis and HIV disease progression in a high tuberculosis prevalence area. Int J Tuberc Lung Dis. 2001 Mar;5(3):225-32.

Reference Type BACKGROUND
PMID: 11326821 (View on PubMed)

Friedland G, Harries A, Coetzee D. Implementation issues in tuberculosis/HIV program collaboration and integration: 3 case studies. J Infect Dis. 2007 Aug 15;196 Suppl 1:S114-23. doi: 10.1086/518664.

Reference Type BACKGROUND
PMID: 17624820 (View on PubMed)

Kwara A, Flanigan TP, Carter EJ. Highly active antiretroviral therapy (HAART) in adults with tuberculosis: current status. Int J Tuberc Lung Dis. 2005 Mar;9(3):248-57.

Reference Type BACKGROUND
PMID: 15786886 (View on PubMed)

Maher D, Harries A, Getahun H. Tuberculosis and HIV interaction in sub-Saharan Africa: impact on patients and programmes; implications for policies. Trop Med Int Health. 2005 Aug;10(8):734-42. doi: 10.1111/j.1365-3156.2005.01456.x.

Reference Type BACKGROUND
PMID: 16045459 (View on PubMed)

Perkins MD, Cunningham J. Facing the crisis: improving the diagnosis of tuberculosis in the HIV era. J Infect Dis. 2007 Aug 15;196 Suppl 1:S15-27. doi: 10.1086/518656.

Reference Type BACKGROUND
PMID: 17624822 (View on PubMed)

Wood R, Maartens G, Lombard CJ. Risk factors for developing tuberculosis in HIV-1-infected adults from communities with a low or very high incidence of tuberculosis. J Acquir Immune Defic Syndr. 2000 Jan 1;23(1):75-80. doi: 10.1097/00126334-200001010-00010.

Reference Type BACKGROUND
PMID: 10708059 (View on PubMed)

Other Identifiers

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U19AI053217

Identifier Type: NIH

Identifier Source: secondary_id

View Link

CIPRA-SA Project 3B

Identifier Type: -

Identifier Source: org_study_id

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