Tuberculosis Clinical Trial
Official title:
Z 31411 - The Effect of Xpert MTB/RIF on Patient Health Outcomes and Empirical TB Treatment Among Persons Living With HIV/AIDS: A Parallel-Group Prospective Cohort Study Under Real-World Conditions in Lusaka, Zambia
A parallel-group prospective cohort study among adult persons living with HIV/AIDS to study the effect of a new TB diagnostic test, Xpert MTB/RIF on: 1) TB case detection; 2) time to TB diagnosis and TB treatment; 3) presumptive TB patient drop-out from the TB diagnostic "cascade" before starting TB treatment; and 4) loss to follow-up after initiation of TB treatment.
The Centre for Infectious Disease Research in Zambia (CIDRZ) in collaboration with the
Zambian National TB Program (NTP) and the Ministry of Health (MOH) will provide near
point-of-care Xpert testing at a high-volume anti-retroviral treatment (ART) clinic in
Lusaka, Zambia. A total 892 study participants will be enrolled into two parallel cohorts—an
"Xpert" and a "standard of care" (SOC) cohort over a 7-month period. The Xpert cohort will
enrol participants at the health centre implementing Xpert. The SOC cohort will enrol
participants from one health centre offering the standard of care (sputum smear microscopy
plus clinical evaluation). A parallel-group prospective cohort study will be conducted by
following participants in one cohort from each site for 210 days from the time of sputum
submission, allowing sufficient person-time to observe all outcomes of interest, including
completion of a standard course of ATT as well as patient drop-out and loss to follow-up.
A systematic facility assessment survey using an adapted version of the WHO Service
Availability and Readiness Assessment tool will be conducted. Key informants will be
interviewed.
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