Tuberculosis (TB) Key Facts
A total of 1.3 million people died from TB in 2022 (including 167 000 people with HIV). Worldwide, TB is the second leading infectious killer after COVID-19 (above HIV/AIDS).
In 2022, an estimated 10.6 million people fell ill with tuberculosis (TB) worldwide, including 5.8 million men, 3.5 million women and 1.3 million children. TB is present in all countries and age groups. But TB is curable and preventable.
Globally, TB incidence is falling at about 2% per year. This was over half way to the End TB Strategy milestone of 20% reduction between 2015 and 2020.
In 2022, 1.3 million children fell ill with TB globally. Child and adolescent TB is often overlooked by health providers and can be difficult to diagnose and treat.
In 2021, the 30 high TB burden countries accounted for 87% of new TB cases.
Multidrug-resistant TB (MDR-TB) remains a public health crisis and a health security threat. Only about two in five people with drug resistant TB accessed treatment in 2022.
An estimated 75 million lives were saved through TB diagnosis and treatment since the year 2000.
Ending the TB epidemic by 2030 is among the health targets of the Sustainable Development Goals.
Summary of the project
The problem
Despite efforts to improve early case detection, tuberculosis (TB) disease incidence in Africa remains high. Over 200 million Africans have latent TB infection (LTBI) from which new disease will occur.
Limitations
Scale-up of preventive treatment for LTBI can significantly reduce TB morbidity, mortality and transmission, but is hampered by our poor ability to predict who will progress from LTBI to TB disease in near future
Incipient TB (PreFIT) is a research and capacity building project funded by the European-Developing Countries Clinical Trials Platform (EDCTP), a mechanism under the EU’s Horizon 2020 research program.
Objective
PreFIT aims to validate ready-to-use candidate assays for incipient TB in populations of intended use across different High burden settings in Mozambique, South Africa and Uganda
These include a GeneXpert cartridge-based 3-gene signature, C-reactive protein, hemoglobin and markers of iron homeostasis. PreFIT will establish a diagnostic trial cohort of 4040 highly exposed HIV-negative and positive TB-free contacts followed prospectively for development of culture-confirmed TB disease for 12 months with candidate testing at months 0 and 6 (Figure 1). The assays will be validated for clinical performance to predict TB disease, feasibility and cost when used at point-of-care.
Impact
The project will deliver robust estimates of predictive performance for each candidate assay and for various combinations of assays, allowing cost-optimized algorithms to be defined
PreFIT’s results will contribute to WHO endorsement and CE marking of successful candidates meeting the TPP
It in addition aims to strengthen the capacity of the African clinical institutions in the consortium through training, technical assistance and enabling storage of the cohort samples to support future research. To this end it will collaborate with EDCTP’s Networks of Excellence TESA (Southern Africa) and EACCR (Eastern Africa).
