Tuberculosis in Rural and Malnourished Populations

NCT ID: NCT06971952

Last Updated: 2025-05-14

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

360 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-06-01

Study Completion Date

2030-09-01

Brief Summary

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Background: Tuberculosis (TB) remains a large public health threat in Tanzania with an estimated incidence of 195 per 100,000 people in 2022 and 36% of cases going undiagnosed. Nutritional and financial barriers combine to compound the burden of TB in Tanzania and many other high burden countries.

Objectives: In this study, we aim to evaluate the effect and cost-effectiveness of conditional cash transfer added to the current facility-based approach to improve TB screening among household contacts (HHCs) of index people diagnosed with TB disease (PWTB) in rural Tanzania; and characterize the prevalence of undernutrition among HHCs of index PWTB and quantify the effect of undernutrition severity on the progression to active TB disease.

Methods: In this prospective, interventional cohort study we plan to enroll 360 PWTB and their households within 2 months of TB treatment initiation. The duration of the study is 3 years in total: 2-year enrollment period, divided equally between the current standard of care phase and the added conditional cash transfer phase. All participating households will be visited 2 months after enrollment to complete TB screening for all HHCs and perform anthropometric measurements, and then followed a 2-year period to evaluate for incident TB disease among HHCs.

Data analysis: The proportion of households completing TB screening procedures for all HHCs during phase 1 will be compared to that during phase 2 using a chi-square test to evaluate the effect of conditional cash transfer on completion of HHC TB screening. A similar approach will be used to compare proportions of HHCs diagnosed with active TB disease based on nutritional status. We will use regression and Bayesian modeling to quantify the effect of demographic, nutritional and socioeconomic predictors on completion of HHC TB screening and the incidence of TB disease among HHCs to prioritize higher risk subgroup for TB prevention effort.

Impact: Successful completion of this proposal will informTB programs in many high burden countries with implementable interventions that can be scaled in rural communities to prioritize TB prevention efforts to the HHCs at the highest risk of developing TB disease

Detailed Description

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Conditions

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Tuberculosis (TB) Undernutrition

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

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Facility-based Household Contact Screening

a studied, 12-month lead-in period to prospectively measure facility-based household tuberculosis (TB) screening activities in collaboration with TB Clinic Staff at Haydom Lutheran Hospital. Index people with TB (PWTB) will be consecutively recruited to passively track their TB course and that of their household contacts over a 2-month period

Group Type NO_INTERVENTION

No interventions assigned to this group

Conditional Cash Transfer Incentive for Household Contact Screening

Households with index people with TB (PWTB) will be consecutively recruited and offered a conditional cash transfer once all HHCs complete the facility-based tuberculosis (TB) screening procedures. The participants will be notified of the cash transfer during the consenting process for this phase. They will be informed that if all household contacts complete the recommended TB screening, the cash transfer will be given to the head of household during the home visit at 2 months.

Group Type ACTIVE_COMPARATOR

Conditional Cash Transfer Incentive for Household Contact Screening

Intervention Type BEHAVIORAL

Households with index people with TB (PWTB) will be consecutively recruited and offered a conditional cash transfer once all HHCs complete the facility-based tuberculosis (TB) screening procedures. The participants will be notified of the cash transfer during the consenting process for this phase. They will be informed that if all household contacts complete the recommended TB screening, the cash transfer will be given to the head of household during the home visit at 2 months.

Interventions

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Conditional Cash Transfer Incentive for Household Contact Screening

Households with index people with TB (PWTB) will be consecutively recruited and offered a conditional cash transfer once all HHCs complete the facility-based tuberculosis (TB) screening procedures. The participants will be notified of the cash transfer during the consenting process for this phase. They will be informed that if all household contacts complete the recommended TB screening, the cash transfer will be given to the head of household during the home visit at 2 months.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Index person/people diagnosed with drug sensitive pulmonary tuberculosis disease (PWTB) and starting TB treatment within 2 months of enrollment, of any age.
* Index PWTB are eligible if they reside within the catchment area of Haydom Lutheran Hospital (HLH), and
* Index PWTB intend to receive TB care at a participating study site.
* Index PWTB (or their parent or guardian if index PWTB are \<18 years) and head of household (if different from index PWTB) are able and willing to provide informed consent.

Exclusion Criteria

* Inability to provide informed consent, or assent when applicable.
* Residing or receiving TB care outside of the catchment area of study sites
* Prior completion of TB screening procedures for all household members.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Burroughs Wellcome

INDUSTRY

Sponsor Role collaborator

The American Society of Tropical Medicine and Hygiene

OTHER

Sponsor Role collaborator

University of Virginia

OTHER

Sponsor Role lead

Responsible Party

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Ghassan Ilaiwy

Visiting Assistant Professor Department of Medicine, Division of Infectious Diseases and International Health

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Tania Thomas, MD MPH

Role: PRINCIPAL_INVESTIGATOR

University of Virginia

Locations

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Haydom Lutheran Hospital

Haydom, Manyara Region, Tanzania

Site Status

Countries

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Tanzania

Central Contacts

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Ghassan Ilaiwy, MD MPH

Role: CONTACT

434.297.9460

Tania A. Thomas, MD MPH

Role: CONTACT

434.243.9592

Facility Contacts

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Estomih Mduma, PhD

Role: primary

0755876879

Saning'o Lukumay

Role: backup

+255 (0) 627724498

Other Identifiers

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HSR230322

Identifier Type: -

Identifier Source: org_study_id

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