Whole Genome Sequencing of Tuberculosis for Disease Control in Madagascar

NCT ID: NCT05406453

Last Updated: 2024-10-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

98362 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-05-16

Study Completion Date

2024-06-30

Brief Summary

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Tuberculosis (TB) whole genome sequencing (WGS) allows outbreak identification and disease transmission tracking.

It is hypothesized that prospective WGS-guided epidemiological investigations improve case detection compared to current best practices by adapting contact tracing strategies to local transmission patterns.

A cluster randomized controlled trial (cRCT) will be performed in high TB incidence villages of Haute Matsiatra region in Madagascar. Communities will be randomized in three separate TB control strategies comparing (1) standard of care, (2) the World Health Organization (WHO) recommended best practices and (3) a novel intervention involving TB WGS cluster-guided epidemiological investigations. The incremental value of TB WGS on case notifications and reduction of TB burden will be measured.

Secondary studies will be nested within this cRCT will include:

* A qualitative study which will increase the understanding of the factors facilitating and hindering implementation of WGS-based diagnostics within health systems.
* A cost effectiveness analysis study which will measure the cost effectiveness of newly implemented laboratory methods.

Field and genomic epidemiology data from this project will inform future work on the design of community-level TB elimination strategies in collaboration with Madagascar National TB program

Detailed Description

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Conditions

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Tuberculosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

cRCT
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Madagascar standard of care

Description :

* Passive case finding,
* Smear microscopy testing, and
* household contact tracing

Group Type NO_INTERVENTION

No interventions assigned to this group

Best practices

Description :

* Active case finding,
* Smear microscopy
* Xpert MTB/RIF Ultra testing (= rapid test by Genexpert for tuberculosis (TB) and rifampin resistance (RIF-R)) and
* household contact tracing

Group Type NO_INTERVENTION

No interventions assigned to this group

Novel intervention

Description :

* Active case finding,
* Smear microscopy
* Xpert MTB/RIF Ultra testing and
* household contact tracing

Group Type EXPERIMENTAL

Whole Genome Sequencing testing

Intervention Type OTHER

Whole Genome Sequencing testing, community-based contact tracing

Interventions

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Whole Genome Sequencing testing

Whole Genome Sequencing testing, community-based contact tracing

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Subjects suspected TB
* subject living in the study area

Exclusion Criteria

* unable to take a sputum sample
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The National Tuberculosis Program, Madagascar

UNKNOWN

Sponsor Role collaborator

Centre de Recherche du Centre Hospitalier de l'Université de Montréal

OTHER

Sponsor Role collaborator

Institut Pasteur de Madagascar

OTHER

Sponsor Role lead

Responsible Party

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Simon Grandjean Lapierre

Researcher

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Simon Grandjean Lapierre, MD MSc FRCPC

Role: PRINCIPAL_INVESTIGATOR

CHUM

Locations

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Fokontany Vohibato

Vohibato, , Madagascar

Site Status

Countries

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Madagascar

References

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Ametepe ESA, Andriamanoha N, Andrianomanana FR, Point F, Mangahasimbola RT, Dyachenko A, Hall M, Gamana TM, Knoblauch AM, Razafindrasoa YY, Nimalan A, Behr M, Durand M, Johri M, Iqbal Z, Rakotoarivelo AR, Randremanana RV, Rakotosamimanana N, Lapierre SG. Whole genome sequencing of M. tuberculosis for disease control in high-burden settings: study protocol for a cluster randomized controlled trial evaluating different community-wide intervention strategies in rural Madagascar. Trials. 2024 Oct 25;25(1):717. doi: 10.1186/s13063-024-08537-4.

Reference Type DERIVED
PMID: 39456079 (View on PubMed)

Other Identifiers

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PJT 75243

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

2022-01

Identifier Type: -

Identifier Source: org_study_id

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