Windhoek

Drug-resistant tuberculosis (DR-TB) is a serious health problem in Namibia, with many new cases each year including multidrug-resistant (MDR) and extensively drug-resistant (XDR) forms. This research aims to better understand the spread of DR-TB by studying clinical, social, and geographical data to find areas with high transmission. The study also evaluates new ways to identify cases early and develops a model predicting the impact of these strategies on DR-TB rates. The study includes all DR-TB cases from three regions in Namibia: Khomas, Otjozondjupa, and Ohangwena. Researchers collect detailed information and perform whole genome sequencing on bacterial samples to track disease spread and resistance patterns. They also study household members, hospital visitors, and community members in transmission hotspots to test new case finding methods. Participants provide clinical, epidemiological, social, and laboratory data, including results from GeneXpert MTB/RIF tests and cultures. Data collected will help identify transmission hotspots and assess intervention feasibility through questionnaires over 18 to 24 months. A transmission model with economic analysis will be developed to support future DR-TB control policies. The study’s findings aim to improve diagnosis, surveillance, and resource use in Namibia and beyond.

Researchers are conducting an international, multi-center, open-label randomized controlled trial called TRICS-IV to compare two blood transfusion strategies in patients aged 18 to 65 years undergoing cardiac surgery with cardiopulmonary bypass. The study focuses on moderate to high-risk patients and aims to evaluate which transfusion threshold may lead to better outcomes after surgery. Participants will be assigned to one of two groups. The restrictive transfusion group will receive red blood cell transfusions only if their hemoglobin levels fall below 75 g/L during or after surgery. The liberal transfusion group will receive transfusions if their hemoglobin drops below 95 g/L during surgery or in the intensive care unit after surgery, or below 85 g/L on the ward. The study compares these two commonly used approaches to transfusion management. During the study, participants will be monitored for up to six months after surgery. Researchers will track a combined measure that includes death from any cause, heart attacks, new kidney failure requiring dialysis, or new strokes. Participants will be assessed through clinical follow-up to determine how these events relate to the transfusion strategy they received. This long-term monitoring will help evaluate the safety and outcomes of the different transfusion thresholds.