Southern Africa is the region of the world most heavily burdened by HIV/TB and TB drug resistance. TB is the most common cause of death among people living with HIV. Accurate, timely diagnoses of TB and TB drug resistance are essential for appropriate treatment regimens in lower income settings. There is an urgent need for rapid, culture-independent tools for diagnosing TB drug resistance for people receiving care in less centralized clinics and rapidly initiating appropriate treatment regimens to improve treatment success rates. Preventing TB and particularly drug-resistant TB through preventive treatment remains an important public health goal to avoid long, toxic treatment regimens and catastrophic economic costs.
Prof. Lukas Fenner and his team from ISPM and the HIV, Hepatitis and Tuberculosis research group aim to advance genomic TB drug resistance testing, understand the preventive TB care cascade, and assess HIV and TB public health epidemiology among individuals with lower income compared with higher income. Comparing different public health approaches to diagnose, treat, and prevent drug-resistant TB in lower and higher income settings leads to better understanding control program strategies. Prof. Fenner’s supplement funding addresses these areas and takes advantage of ongoing studies in the IeDEA Southern African region.
A second supplement grant supports Dr. Eliane Rohner – head of the Cancer research group – and the on-going South African HIV Cancer Match (SAM) study. The collaborative study team includes members from the National Cancer Registry in South Africa, ISPM, and Swiss TPH. SAM is a large record linkage study based on laboratory data from the National Health Laboratory Services and NCR in South Africa. The record linkage was performed using a privacy-preserving probabilistic record linkage (P3RL) encryption tool co-developed at ISPM. The current SAM database includes information about more than 5 million people living with HIV in South Africa1. With the supplement grant, Dr. Rohner and the study team plan to enrich the SAM database by adding mortality data for a subset of individuals through linkage with the National Population Register and building an HIV-negative control cohort of individuals regularly monitored for the chronic disease diabetes mellitus.
1 Muchengeti M, Bartels L, Olago V, et al. Cohort profile: the South African HIV Cancer Match (SAM) Study, a national population-based cohort. BMJ Open 2022; 12:e053460.