Evaluating the effectiveness of TB preventive treatment

The CDC Foundation, together with the CDC’s Centre for Global Health and in partnership with Emory University, and funding from the Bill and Melinda Gates Foundation, are conducting a project named TB PROTECT, which aims to evaluate the impact of expanding TB preventive treatment (TPT) on TB cases and deaths among people living with HIV (PLHIV). The evaluation is being conducted in 6 countries namely, Uganda, Kenya, Zimbabwe, Nigeria, Haiti, and Ukraine.

TB is a major cause of illness and death among people living with HIV, accounting for up to 30% of HIV-related deaths. Although there has been progress in treating HIV globally and there is evidence showing the effectiveness of TPT and antiretroviral therapy (ART) in reducing TB-related illness and deaths, not enough people are receiving TPT.

In 2018, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) pledged to provide TPT to all 14.6 million people living with HIV by the end of 2025. While some progress has been made, we still do not know the overall impact of implementing large scale TPT programs on TB rates and deaths.

In Uganda, the TB PROTECT project is being implemented by the Ministry of Health, Makerere University School of Public Health Monitoring and Evaluation Technical Support Program (MakSPH/ METS) and 17 HIV implementing partners across 54 health facilities. To assess the implementation status of the project, METS hosted this year’s TPT PROTECT Workshop with the main objective of reviewing progress across the implementing countries.

The 3-day workshop (15-17 May 2023) created a platform to share overviews on country TB/HIV programs, findings from Data Quality Assessments, complexities encountered in implementation of the programs as well as insights into best practices.

Other areas of focus included evaluating the completeness and quality of country Electronic Medical Records (EMR) data to understand potential gaps and determine how these can be addressed, discuss key challenges for TPT scale-up and consider strategies for a meta- analysis of data from countries.

The workshop was officially opened by Dr. Lisa Nelson, the CDC Country Director and was attended by Makerere University School of Public Health Dean, Professor Rhoda Wanyenze, Dr. Prossy Namuwenge from the National TB Program at the Ministry of Health.

The delegates participated in site visits to Kisenyi HCIV and Makerere University Hospital where they visited TB treatment clinics, laboratory, Electronic Medical Records, and records section.

The project’s next steps include determining clear timelines for data analysis and discussions on dissemination plans for country stakeholders and the global community and developing timelines for capacity building activities.