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TuberculosisERASE-TBNCT04781257

Early Risk Assessment in Household Contacts (≥10 Years) of TB Patients by New Diagnostic Tests in 3 African Countries

An observational study of Tuberculosis, run by Michael Hoelscher at 3 sites in 3 countries.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The ERASE - TB study will be conducted in order to fill a critical unmet need for tuberculosis control. Persons who are in contact with an infectious TB case may become infected themselves. Among those who are infected, most will stay healthy but some will develop TB themselves. Read more about this study

Who is it for?
Ages 10 years and olderHealthy volunteers can take part
Conditions the study is for
Tuberculosis
What is being tested?
New test candidates
How many people
2,100 participants
Where
3 sitesin 3 countries
Study dates
1 Mar 2021to 30 Apr 2024
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 10 years and older
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Study population: TB index cases will be recruited at the primary health care clinics where the patient is receiving TB treatment. Household contacts have substantial recent exposure to the TB index case in the household (defined as sleeping at least 3/7 nights in the same household in the last 4 weeks).

Who may be able to join

  • TB index case:
  • Aged at least 18 years
  • Having at least one other person living in the household aged ≥10 years
  • Written informed consent to conduct socio-economic and clinical questionnaire, to provide a sputum sample for culture and sequencing, and to approach the household members.
  • Recently diagnosed with active pulmonary TB within the last 4 weeks
  • Has taken less than 7 daily doses of anti-TB treatment since diagnosis; ensuring a positive culture can still be obtained
Show all 14Show fewer
  • Able to spontaneously produce sputum
  • Sputum microscopy positive in Ziehl-Neelsen or Auramine-O staining of ideally 2+ or higher, but at least 1+ on the IUATLD/WHO scale, OR (in case no sputum microscopy done) GeneXpert positive, at least TB "medium"
  • A firm home address, maintained unchanged for the last 6 months, that is accessible to visiting
  • Household Contact:
  • Aged at least 10 years
  • Written informed consent for study participation, including HIV testing, and home visits by the study team for follow-up (for minors <18 yr.: consent of the parent/guardian, assent of the participant)
  • Recent (in the last 4 weeks), substantial exposure to an infectious TB case in the household, defined as sleeping at least 3/7 nights in the same household
  • If HIV negative: not on preventive therapy (preventive therapy is not an exclusion criterion for HIV positive persons)

Who cannot join

  • Household Contact
  • Circumstances that raise doubt on free, uncoerced informed consent (e.g. in a mentally handicapped person)
  • Prisoners
  • Recent treatment for active TB, completed within the last 30 days OR on current TB treatment for active TB.

Trial locations and contacts

3 sites in 3 countries.

3 sites in 3 countries

Mozambique1 site
  • Instituto Nacional de Saúde (INS) Centro de Investigação e Treino em Saúde da Polana Caniço

    Maputo

Other trials in Mozambique

Tanzania1 site
  • NIMR - Mbeya Medical Research Centre

    Mbeya

Other trials in Tanzania

Zimbabwe1 site
  • Biomedical Research & Training Institute (BRTI)

    Harare

Other trials in Zimbabwe

About this study

Official title: Early Risk Assessment in TB contactS by New Diagnostic tEsts

The ERASE - TB study will be conducted in order to fill a critical unmet need for tuberculosis control. Persons who are in contact with an infectious TB case may become infected themselves. Among those who are infected, most will stay healthy but some will develop TB themselves.

These people would benefit from preventive treatment, which would also stop TB from being spread to other persons.

Read more

The problem currently is that it is impossible to determine with certainty who would require preventive treatment, and who will remain healthy. Out of 100 persons exposed to an infectious TB patient, only 2 will go on to have TB according to a study in Vietnam, but there are no good tests available to identify those with a risk for TB disease. Treating 100 persons to prevent 2 cases of TB is not effective, so preventive treatment is not used in adults and adolescents in Tanzania, Mozambique and Zimbabwe, where this study will be conducted, but also in many other settings.

The ERASE - TB project will evaluate a number of newly developed diagnostic tests, to see which of those will be able to predict TB in persons at risk, and therefore steer preventive treatment well.

For this, the investigators will invite 2,100 household contacts (HHC) of infectious TB patients, who are at least 10 years old, into the study. Everyone will be examined initially, and again in regular intervals, for 1.5 to 2 years; and whenever the participants will present with symptoms that could indicate that they develop TB.

At every visit, the investigators will perform an X-ray and take some blood and urine samples to perform new candidate tests. At the first/baseline visit, all household contacts without TB will undergo a spirometry to evaluate their pulmonary function.

If someone is unwell, the investigators will also examine sputum for the presence of TB bacilli. In the end, the investigators will then be able to say who of the persons in the study developed TB, and who remained healthy. From all samples taken at different timepoints, the investigators will then determine which test found TB early, and clearly distinguished between persons developing TB, and persons who would remain healthy .

Conditions
Tuberculosis
Being tested
New test candidates
Keywords
Tuberculosis, Latent Tuberculosis, Pulmonary Tuberculosis, Case-Control Studies, Disease Transmission, Infectious, Blood Specimen Collection, Urine Specimen Collection, Sputum, Diagnostic Techniques and Procedures, Biomarkers, Interferon-gamma Release Tests, Mass Chest X-ray, Radiography, Respiratory Function Tests, Spirometry, Artificial Intelligence, Transcriptome, Biological Specimen Banks, Models, Theoretical, Housing
Medical subject headings
Tuberculosis, Latent Tuberculosis, Tuberculosis, Pulmonary, Communicable Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • New test candidatesDiagnostic test

    The following new diagnostic tests will be done after the completion of the study with the samples (blood, sputum, urine) and data (digital X-ray) obtained during the study period:

    CAD4TB / qXR Xpert Ultra® FLOW-TB TAM-TB 4RISK and COR Cepheid 3-gene signature cartridge BioMérieux ISIT TB blood transcription signature assay Multiplex LSHTM in-house host biomarker assay TB Screen biosignature SeroSelect

    Retrospective testing of participants' samples and data acquired during the study period, differentiated between participants with co-prevalent/incipient TB and participants staying health throughout the trial

Study groups in NCT04781257
Study groupRoleWhat they receive
Household contacts with co-prevalent/incipient TBHousehold contacts diagnosed with active TB at baseline/during the study period
Receives: Diagnostic Test: New test candidates
Household contacts staying healthyHousehold contacts without active TB who remain healthy throughout the study
Receives: Diagnostic Test: New test candidates

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Sensitivity and specificity of new diagnostics to diagnose co-prevalent TB against a clinica/microbiological reference standard case definition

    to determine sensitivity and specificity of new diagnostics for diagnosing TB earlier with a special focus on subclinical disease.

    New diagnostics will be evaluated against a reference standard for classification of presence of, or development of TB disease in a person exposed to a source case; with the following possibilities:

    • Co--prevalent symptomatic TB
    • Co--prevalent subclinical TB
    • Minimal TB, with incident TB during follow-up
    • Remained healthy

    Measured: Co-prevalent TB disease can be diagnosed at Baseline (Month 0)

  2. Evaluation of novel diagnostics for detection of developing, minimal TB against a clinica/microbiological reference standard case definition

    to evaluate novel diagnostics for detection of developing, minimal TB that would cause infectious disease in the future.

    For reference standard case classification, see 1.

    Measured: TB disease can be diagnosed through study completion, up to Month 24

  3. Enhancement of diagnostic performance by simulating testing algorithms coupled with a risk estimate from a mathematical model

    to enhance diagnostic performance by simulating testing algorithms coupled with a risk estimate from a mathematical model For reference standard case classification, see 1.

    Measured: TB disease can be diagnosed through study completion, up to Month 24

Secondary outcomes (3)
  1. M.tb infection status as measured by an immunological assay

    M.tb infection status as measured by an immunological assay:

    • M.tb infected at baseline
    • M.tb uninfected at baseline through to end of study
    • Change of M.tb infection status from negative (baseline) to positive during follow-up

    Measured: through study completion, up to Month 24

  2. Classification of cases of co-prevalent or incident TB; through M.tb isolate sequencing and comparison with the source case isolate

    Classification of cases of co-prevalent or incident TB; through M.tb isolate sequencing and comparison with the source case isolate:

    • Secondary, infected by source case - defined timepoint of infection
    • Other, unknown source of infection - unknown timepoint of infection

    Measured: through study completion, up to Month 24

  3. Assessment of the proportion of HHC (without co-prevalent TB) with abnormal pulmonary function at baseline

    to assess the proportion of HHC (without co-prevalent TB) with abnormal pulmonary function at baseline, the type and severity of impairments, the relationship between pre-existing abnormal pulmonary function and incident TB (and the changes in pulmonary function measured by spirometry after incident TB and TB treatment completion).

    Measured: Spirometry will be done only at baseline

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Mar 2021
  2. Study start1 Mar 2021
  3. Primary completion30 Apr 2024 (estimated)
  4. Study completion30 Apr 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
2,100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04781257
Sponsor's protocol ID
LMU-IMPH-AIDA-03
Acronym
ERASE-TB
Status last verified
Nov 2023
First submitted
21 Dec 2020
Last updated
28 Nov 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided: Accordance with EU General Data Protection Regulation and local data protection law needs to be worked out.

Publications

  • Drain PK, Bajema KL, Dowdy D, Dheda K, Naidoo K, Schumacher SG, Ma S, Meermeier E, Lewinsohn DM, Sherman DR. Incipient and Subclinical Tuberculosis: a Clinical Review of Early Stages and Progression of Infection. Clin Microbiol Rev. 2018 Jul 18;31(4):e00021-18. doi: 10.1128/CMR.00021-18. Print 2018 Oct.

    PubMed 30021818
  • Fox GJ, Nhung NV, Sy DN, Hoa NLP, Anh LTN, Anh NT, Hoa NB, Dung NH, Buu TN, Loi NT, Nhung LT, Hung NV, Lieu PT, Cuong NK, Cuong PD, Bestrashniy J, Britton WJ, Marks GB. Household-Contact Investigation for Detection of Tuberculosis in Vietnam. N Engl J Med. 2018 Jan 18;378(3):221-229. doi: 10.1056/NEJMoa1700209.

    PubMed 29342390
  • Swindells S, Ramchandani R, Gupta A, Benson CA, Leon-Cruz J, Mwelase N, Jean Juste MA, Lama JR, Valencia J, Omoz-Oarhe A, Supparatpinyo K, Masheto G, Mohapi L, da Silva Escada RO, Mawlana S, Banda P, Severe P, Hakim J, Kanyama C, Langat D, Moran L, Andersen J, Fletcher CV, Nuermberger E, Chaisson RE; BRIEF TB/A5279 Study Team. One Month of Rifapentine plus Isoniazid to Prevent HIV-Related Tuberculosis. N Engl J Med. 2019 Mar 14;380(11):1001-1011. doi: 10.1056/NEJMoa1806808.

    PubMed 30865794
  • Larsson L, Olaru ID, Behnke AL, Marambire ET, Chipinduro M, Calderwood CJ, Banze D, Mfinanga A, Nhamuave C, Mwambola HL, Held K, Gupta RK, Minja LT, Khosa C, Heinrich N, Kranzer K; ERASE-TB consortium. Diagnostic and prognostic accuracy of the Mycobacterium tuberculosis host response 3-gene cartridge among tuberculosis household contacts in Mozambique, Tanzania, and Zimbabwe: a prospective, longitudinal, diagnostic and prognostic accuracy cohort study. Lancet Infect Dis. 2026 Aug;26(8):858-870. doi: 10.1016/S1473-3099(26)00114-3. Epub 2026 Apr 20.

    PubMed 42026013
  • Marambire ET, Banze D, Mfinanga A, Mutsvangwa J, Mbunda TD, Ntinginya NE, Celso K, Kallenius G, Calderwood CJ, Geldmacher C, Held K, Appalarowthu T, Riess F, Panzner U, Heinrich N, Kranzer K; ERASE-TB Consortium. Early risk assessment in paediatric and adult household contacts of confirmed tuberculosis cases by novel diagnostic tests (ERASE-TB): protocol for a prospective, non-interventional, longitudinal, multicountry cohort study. BMJ Open. 2022 Jul 19;12(7):e060985. doi: 10.1136/bmjopen-2022-060985.

    PubMed 36427173

Questions about this trial

What is this clinical trial studying?

An observational study of Tuberculosis, run by Michael Hoelscher at 3 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 14 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 28 Nov 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Mozambique, Tanzania, Zimbabwe. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Sensitivity and specificity of new diagnostics to diagnose co-prevalent TB against a clinica/microbiological reference standard case definition (time frame: Co-prevalent TB disease can be diagnosed at Baseline (Month 0)). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04781257, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Nov 2023.

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