Project: Translation research into policy and practice: Scaling up Evidence Based Multiple focus Integrated Intensified TB Screening to End TB (EXIT-TB) in the East African region

Acronym EXIT-TB (Reference Number: CSA2016S-1608)
Duration 01/04/2018 - 31/03/2021
Project Topic Tuberculosis (TB) remains a major cause of morbidity and mortality especially in sub-Saharan Africa. This high burden is mainly attributed to low case detection and delayed diagnosis. Recently, country surveys have showed unacceptable high prevalence of confirmed TB even among those with a low duration cough and more than 50% of those with prevalent bacteriologically confirmed pulmonary TB do not report symptoms that correspond to presumptive TB. Furthermore, there is an increase in incidence ofsmear negative pulmonary TB patients who can serve as source of infection. In view of the foregoing, aggressive control measures are essential.We are seeking to accelerate the translation of research into policy and practice through Evidence Based Multiple focus Integrated Intensified TB Screening package (EXIT-TB). The EXIT-TB package will involve intensified passive TB case finding (screening all patients at the Outpatient department (OPD) who passively report any cough irrespective of duration); integrating TB case finding activities into reproductive and child health clinics (RCH) and diabetics clinics; screening for TB irrespective of symptoms among HIV/AIDS infected individuals with advanced diseases attending Care and Treatment Centres (CTC), and targeted contact tracing for all TB patients with child household members.The EXIT-TB package is a set of interventions proved to be working under research conditions. A publication from Ethiopia and South Africa and the findings published in BMC and PHA (IUTLD) journals showed significant number of bacteriologically confirmed TB among patients attending OPD and RCH with a cough of less than two weeks. Findings published in the Lancet suggest that ifsputum is requested irrespective of symptoms, 13% of patients in this group will be diagnosed with TB, of which only 38% of the diagnosed TB patients will have a cough.Given the proven scientific evidence, it is believed that, the EXIT-TB package will increase TB case detection, reduce TB diagnostic and treatment delays and increase number of TB patients put into TB care including women and children. The implementation research goals will be achieved through 4 essential steps, namely: 1) translation, 2) dissemination, 3) adoption/diffusion of innovative intervention and 4) effective implementation. Sputum and stool and test will be collected for TB using GeneXpert or sputum smear microscopy and culture (as a gold standard) and house hold contact tracing targeting children with household members with TB will be conducted. In addition, children will be screened using TB screening tool and other confirmatory tests.
Network EDCTP2
Call Strategic actions supporting health systems/services optimisation research capacities in cooperation with development assistance initiatives

Project partner

Number Name Role Country
1 National Institute for Medical Research - Tanzania Coordinator Tanzania
3 Addis Ababa University Partner Ethiopia
4 Infectious Diseases Institute Limited Partner Uganda
5 Kenya Medical Research Institute Partner Kenya
6 Liverpool School of Tropical Medicine Partner United Kingdom
7 Makerere University Partner Uganda
8 Ministry of Health - Uganda Partner Uganda
9 Ministry of Health, Community Development, Gender, Elderly and Children Partner Tanzania
10 The Good Samaritan Foundation, Kilimanjaro Christian Medical Centre Partner Tanzania
11 University College London Partner United Kingdom
12 University of Bergen Partner Norway
13 University of Khartoum Partner South Sudan