DeMONSTRATE-TB Study in Ethiopia

NCT ID: NCT06719193

Last Updated: 2024-12-05

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

RECRUITING

Clinical Phase

PHASE2/PHASE3

Total Enrollment

131438 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-02-27

Study Completion Date

2025-01-01

Brief Summary

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Ending the TB epidemic by 2035 in Ethiopia would be possible if TB notification declines by an annual factor of at least 15% from the current notification rate of 132 per 100,000 population. This requires highly effective strategies to reduce TB transmission and maximize TB prevention among populations at risk of developing TB, such as Household contacts and people living with HIV.

The investigators hypothesize that community wide administration of enhanced TPT will accelerate decline in TB incidence rates when combined with an optimized currently recommended comprehensive TB prevention and care packages described below. The investigators further hypothesize that such intervention packages will be acceptable to the community, providers and policy makers, and that they will be cost-effective.

Based on the study results, a TB elimination framework in high burden TB regions and woredas in Ethiopia will be developed, and local evidence to enhance the shift toward TB elimination will be provided as input to the appropriate allocation of resources.

Detailed Description

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Conditions

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Reducing Tuberculosis Incidence

Keywords

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tuberculosis prevalence tuberculosis incidence tuberculosis elimination tuberculosis preventive therapy quasi experimental ethiopia

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

A sequential exploratory mixed-method study with a dominant controlled before-after (or quasi-experimental) design will be the main design of this study, followed by qualitative methods. The aim of the qualitative component is to explore whether the ETB intervention package is feasible and helps achieve TB elimination in Ethiopia. In-depth interviews (IDIs) and focus-group discussions (FGDs) with TB program managers and health extensions workers, community leaders, and selected heads of households involved the study will be conducted.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Enhanced community-wide TB intervention

Enhanced community-wide TB intervention strategy with intensive screening and health education

Group Type EXPERIMENTAL

Enhanced community-wide TB intervention

Intervention Type COMBINATION_PRODUCT

Interventions in the intervention arms consist of the following key components:

1. an optimized national recommended set of interventions; such as the implementation of all types of contact investigation, targeted TB screening and diagnosis at key affected population, and optimized HIV screening and TPT for PLHIV;
2. intensive, active, and community-based HH screening and diagnosis of TB using combined TB screening (clinical and X-ray) and X-pert MTB/RIF, as indicated;
3. community-based enhanced TPT; and
4. community-based awareness creation and health education using the community social associations.

Routine TB program activities

TB standard of care per Ethiopia's national guidelines

Group Type ACTIVE_COMPARATOR

Routine TB program activities

Intervention Type COMBINATION_PRODUCT

In the control arm, the standard of care will continue per the national guideline.

Interventions

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Enhanced community-wide TB intervention

Interventions in the intervention arms consist of the following key components:

1. an optimized national recommended set of interventions; such as the implementation of all types of contact investigation, targeted TB screening and diagnosis at key affected population, and optimized HIV screening and TPT for PLHIV;
2. intensive, active, and community-based HH screening and diagnosis of TB using combined TB screening (clinical and X-ray) and X-pert MTB/RIF, as indicated;
3. community-based enhanced TPT; and
4. community-based awareness creation and health education using the community social associations.

Intervention Type COMBINATION_PRODUCT

Routine TB program activities

In the control arm, the standard of care will continue per the national guideline.

Intervention Type COMBINATION_PRODUCT

Eligibility Criteria

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Inclusion Criteria

1. Adults:

* Greater than or equal to 18 years old
* Provides consent
* Living in study site area (woreda)
2. Children

* Aged 12 to 17 years
* Living in the study site area (woreda)
* Assent to enrollment
* Guardian provides consent for enrollment
3. Younger children:

* Less than 12 years old
* Living in the study site area (woreda)
* Consent for enrollment provided by the guardian

Exclusion Criteria

1. Adults:

* Does not provide consent
* Declines to provide contact information
* Less than 18 years
* Living outside of the study site area
* Declines to allow study staff to contact them by phone and in person if they miss a study visit
2. Children

* Does not provide assent
* Guardian does not provide consent
* Guardian declines to provide contact information
* Not within 12 to 17 years
* Living outside of the study site area
* Guardian declines to allow study staff to contact them by phone and in person if they miss a study visit
3. Younger Children

* Guardian does not provide consent
* Guardian declines to provide contact information
* Not less than 12 years
* Living outside of the study site area
* Guardian declines to allow study staff to contact them by phone and in person if they miss a study visit
Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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KNCV Tuberculosis Foundation

OTHER

Sponsor Role collaborator

Management Sciences for Health

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Gedebe Hassassa woreda

West Arsi Zone, Ormoia Regional State, Ethiopia

Site Status RECRUITING

Boloso Bombe woreda

Wolayita Zone, South Ethiopia Regional State, Ethiopia

Site Status RECRUITING

Countries

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Ethiopia

Central Contacts

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Oumer Ali, PhD

Role: CONTACT

Phone: 617-250-9500

Email: [email protected]

Zewdu Dememew, MD, PhD

Role: CONTACT

Phone: 617-250-9500

Email: [email protected]

Facility Contacts

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Abu Emma

Role: primary

Mulatu Biru, PhD

Role: backup

Dereje Alemu

Role: primary

Mulatu Biru, PhD

Role: backup

Other Identifiers

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72066320CA00009

Identifier Type: OTHER_GRANT

Identifier Source: secondary_id

37.2022

Identifier Type: -

Identifier Source: org_study_id