Enhanced Case Finding for Drug-Resistant Tuberculosis in Namibia Focusing on Hotspots, Households, and Hospitals

What this Trial Is About

Researchers are investigating the spread and control of drug-resistant tuberculosis DR-TB in Namibia, a country with a high burden of TB including multidrug-resistant and extensively drug-resistant cases. The study aims to understand the epidemic by examining clinical, epidemiological, geospatial, social network, and laboratory data to identify transmission hotspots. It also evaluates targeted case finding interventions in high-transmission areas and develops a transmission model to predict the impact of these interventions on DR-TB incidence. The study is observational and includes all DR-TB cases identified in three regions of Namibia. It collects various data including GeneXpert MTBRIF results, cultures, drug sensitivity tests, and whole genome sequencing WGS of Mycobacterium tuberculosis samples. WGS is performed locally with validation abroad. After identifying hotspots, feasibility studies of case finding strategies are conducted in households, hospitals, and communities. These data also support a health economics component to inform resource allocation. Participants provide clinical and social data and undergo laboratory testing. The study includes questionnaires to assess intervention feasibility and collects comprehensive information to inform policy and strengthen diagnosis, surveillance, and control of DR-TB. The research spans several years with outcome measures including hotspot identification over 18 months, intervention feasibility over 24 months, and transmission modeling over 12 months. Participation involves collaboration with national health institutes to capture all possible cases for effective monitoring and intervention planning.

Hotspots, Households and Hospitals: Enhanced Drug-resistant Tuberculosis Case Finding in Namibia