World Patient Safety Day 2024: LINQ projects improving TB diagnostics
17 September has been designated World Patient Safety Day by the WHO, aiming to shed light on the most pressing issues concerning patient safety worldwide. This year, in line with the global theme of “improving diagnosis for improving patients’ safety”, we’ll explore the projects supported by LINQ in which diagnostics play a central role. More specifically, we’ll focus on advancements in diagnosing tuberculosis (TB).
Tuberculosis is one of the top 10 causes of death worldwide, with increased risk among medically vulnerable people, such as those living with HIV. It spreads quickly through air and affects 10 million people every year. The disease is curable but difficult to diagnose, requiring further innovation in the field to improve diagnostics and ensure that patients can access correct treatment faster. The time to diagnosis is especially important, as most deaths from TB are preventable with early detection and appropriate treatment.
The COVID-19 pandemic had a great impact on tuberculosis diagnosis, with a huge decrease in the number of newly diagnosed people between 2019 and 2020. We could also see a trend reversal in the number of deaths: while the annual estimated number of deaths from TB fell between 2005 and 2019, there was an estimated increase between the years 2020 and 2021. The situation has now recovered to around 2019 levels, but it is estimated that the COVID-related disruptions affecting access to diagnosis and provision of treatment led to half a million excess deaths from TB.
LINQ is proud to support several projects that aim to improve TB diagnostics and reduce the time to the initiation of treatment. They include research endeavours supported by various funders (including EDCTP, the NIH, and the Bill and Melinda Gates Foundation) and deal with different stages of the value chain of diagnostic tools, from testing new-generation tools to ensuring usability.
All these projects share a goal: to improve TB diagnosis and minimise the number of preventable deaths.
TriageTB
TriageTB is a project all about timing. And when it comes to TB diagnostics, timing can be key: with faster diagnosis, further spread of the disease can be limited, and the patient can receive timely treatment.
The project set out to develop and test a point-of-care triage test, which is of low complexity and can be used by minimally trained medical staff. It is a rule-out test, which could speed up diagnosis in two ways:
- by ruling out TB for some of the patients presenting with respiratory illness symptoms, it means that they can move on to testing for other diseases swiftly
- for those with a positive result, a high likelihood of TB would be detected right away, and appropriate measures to confirm diagnosis and start treatment can be taken immediately
Trials were run within the project in Uganda, the Gambia, and South Africa. If widely adopted, this kind of test could significantly speed up diagnostic approaches in resource-limited settings.
Learn more about the TriageTB project: https://www.triagetb.com/
ENDxTB
ENDxTB adopts TriageTB’s goals and brings them to the global stage by adding Vietnam to the clinical sites next to South Africa, the Gambia, and Uganda.
In addition to the widened geographical scope, ENDxTB broadened the scientific scope of the study by also looking at pediatric TB patients and household contacts. Through the combined efforts, the partners aim to establish the best tests for different levels of healthcare and different phases of TB infection and disease.
Learn more about the ENDxTB project: https://www.endxtb.com/
TB-CAPT
The TB-CAPT project focuses on increasing access to TB tests and, therefore, faster and more accurate diagnoses. Through a series of trials in Tanzania, Mozambique, and South Africa, TB-CAPT evaluates the most promising new technologies in settings of intended use and develops optimized implementation strategies for novel tests, fully integrating them into the diagnostic and treatment network.
Special focus is given to people living with HIV - for whom TB is the leading cause of death - as novel test technologies have shown promise to improve diagnosis in this population. The aim is to provide evidence for impactful implementation of tuberculosis and TB/HIV co-infection diagnostic strategies.
TB-CAPT clinical trials are designed to consider local epidemiology and existing infrastructure and compare new strategies with current standards of care.
Learn more about the TB-CAPT project: https://www.tb-capt.org/
All these projects, in their own way, contribute to the goal of improving TB diagnostics and disease outcomes. At LINQ, we are passionate about patient care and committed to exploring these topics further, one (ongoing or future) project at a time.