Maseru

Tuberculosis (TB) remains the leading infectious cause of death worldwide and significantly impacts people living with human immunodeficiency virus (PLHIV), especially children and adolescents. These groups face challenges like gaps in preventive care, detection, treatment adherence, and knowledge. This research aims to improve TB detection, testing, and preventive treatment strategies tailored for PLHIV to address these challenges and improve care outcomes. The study evaluates patient-centered TB preventive therapy, where participants who have been ruled out for active TB choose their preferred preventive treatment regimen. Participants are then randomized to receive one of two types of adherence support, including enhanced support through weekly text messages and clinic phone calls. These messages encourage communication with healthcare providers to address questions and improve treatment adherence. Participants will be monitored for TB screening and diagnosis over 24 to 32 months, with prevention outcomes assessed at 48 months. Researchers will also evaluate the cost-effectiveness of the TB preventive treatments over 32 months. The study involves ongoing communication between participants and trained healthcare staff to support adherence and tracks treatment success and safety throughout the study period.

Researchers are investigating community-based, lay-led chronic disease screening and care in rural Lesotho through the ComBaCaL cohort study. This study aims to establish a platform managed by Chronic Care Village Health Workers (CC-VHWs) who use eHealth tools to provide regular screening, monitoring, and referral for chronic diseases like arterial hypertension, diabetes, cardiovascular risk factors, and HIV. The study evaluates how these activities affect disease-specific care cascades such as screening coverage, disease awareness, linkage to care, engagement in care, and disease control over time. The CC-VHWs are trained and equipped with essential tools including blood pressure machines, scales, measuring bands, glucometers, and urine dipsticks. They conduct screenings for warning signs and refer participants to health centers if needed. The workers are supervised by health center nurses through meetings, field visits, and remote communication via a dedicated app. The cohort will also serve as a platform for future nested trials assessing specific chronic disease interventions. Participants will be regularly screened and monitored by CC-VHWs who collect measurements and data using tablet-based eHealth applications. Follow-up assessments occur approximately every six months to track changes in chronic disease indicators and risk factors. The study measures outcomes such as screening coverage, disease awareness, engagement in care, disease control level, and the occurrence of clinical events up to three years after enrollment. Continuous supervision and monitoring ensure quality and support for CC-VHWs throughout the study.