Research to Improve Detection and Treatment of Latent TB Infection
Following declines in the incidence of TB during the 20th century, there was a resurgence of the disease in England from the late 1980s to 2005. Consequently, NHS England and Public Health England (PHE) launched a strategy in 2015 to bring about a sustained decline with screening for LTBI as a funded element of the plan.
LTBI testing and treatment reduces TB incidence by preventing reactivation and is expected to create a cost saving to the NHS after about five years (NHS England). However, high rates of testing, treatment uptake and treatment completion are essential prerequisites to accrue these benefits.
In this 5-year programme of research, we have designed studies to improve access to diagnosis and enhance treatment uptake and completion in individuals with or at risk of LTBI.
Through four interrelated work packages (WP) conducted in parallel, we combine a behavioural science theory-based approach together with clinical trials, health economics and modelling to assess our interventions and meet our objectives.
Studies are conducted in high-volume primary and secondary care settings in England.
We aim to:
- identify the factors influencing uptake of latent TB infection (LTBI) testing and completion of treatment among at-risk populations in the UK
- develop materials to communicate and support LTBI testing and treatment interventions
- evaluate the effectiveness and cost-effectiveness of a new Mycobacterium tuberculosis RD1-specific C-Tb skin test compared to interferon-gamma release-assay (IGRA), and
- assess the effectiveness and cost-effectiveness of a 12-dose rifapentine-based regimen with and without adherence support compared to current standard of care.
- Randomised controlled trial to evaluate the effectiveness of using the RD-1-based C-Tb skin test as a replacement for blood-based interferon-gamma release assay for detection of, and initiation of preventive treatment for, tuberculosis infection: RID-TB:Dx study protocol. BMJ Open, 11 (12), e050595. doi:10.1136/bmjopen-2021-050595
- Evaluating the effect of short-course rifapentine-based regimens with or without enhanced behaviour-targeted treatment support on adherence and completion of treatment for latent tuberculosis infection among adults in the UK (RID-TB:Treat): protocol for an open-label, multicentre, randomised controlled trial. BMJ Open in press
- Evaluating patient education resources for supporting treatment decisions in latent tuberculosis infection. Health Education Journal 2021, Vol. 80(5) 513–528
Screening of patient records to identify individuals who are eligible for routine LTBI screening will be supported by the CRN funded study nurses/clinical research practitioners. The direct care teams at sites will be requested to identify any individuals who have already indicated they do not wish to be contacted about research via the national data opt out, and not pass their details on to the study nurses/clinical research practitioners.
If you believe you are eligible for LTBI screening based on the NHS guidelines, know you are currently a patient at any of the recruiting sites for RID-TB:Dx, and do not wish to be approached about this study, please contact the site to opt-out.