By Wallace Mawire
A major TB study currently underway and aimed at investigating methods to reduce TB prevalence and infection in Zambia and South Africa will soon begin testing for COVID-19 using existing mobile TB testing facilities in the Bwacha – Ngungu community of Kabwe in Zambia.
The 18-month study will be nested within the ongoing TREATS study to measure the prevalence and spread of COVID-19 (SARS-CoV-2) in Zambia working with one urban community with a target population of 28,000. The country has recorded 11,345 confirmed cases with 282 COVID-19 deaths (classified as 89 confirmed COVID-19 deaths and 191 COVID-19 associated deaths), and two deaths pending classification as of 25 August 2020.
The results will be extrapolated to the wider population of Zambia using mathematical modelling, shedding much needed light on the epidemiology of the virus in sub-Saharan Africa, where COVID-19 infections and deaths continue to rise.
“This is a perfect example of collaboration around two separate infectious disease
responses,” said Dr Kwame Shanaube, Project Lead on the TREATS-COVID study. “We are facing an emergency and so absolutely key here is the ability to transfer swiftly the existing TB expertise and infrastructure to COVID-19 testing which will provide immediate benefit to people at risk. Data derived from the study will assist researchers and authorities in developing COVID-19 guidelines in the longer term.”
The TREATS study is currently measuring the impact of a ‘universal test and treat’ intervention called HPTN071/ PopART in reducing the prevalence and incidence of TB in Zambia and South Africa. The study will begin testing for COVID-19 in Bwacha – Ngungu community of Kabwe, Zambia at the end of August 2020.
“The study has the potential to rapidly provide the Ministry with important data on the underlying epidemiology of the disease as well as information on the intersection between TB-HIV and COVID-19,” said Dr Kennedy Malama, Permanent Secretary, Ministry of Health, Zambia.
By optimising existing staff capacity and resources from the TREATS study – such as the innovative OneStopTB truck, which is kitted out with X-Ray and blood testing facilities – the TREATS-COVID study will be able to begin rapidly conducting epidemiological and social science research that will improve the local understanding of COVID-19 transmissibility, susceptibility, disease severity and risk factors as well as measure the prevalence of symptomatic COVID-19 disease in the general population. Household contact tracing will be conducted for COVID-19 positive patients, who will be monitored for development of symptoms and any subsequent illnesses. Crucially, the TREATS-COVID study will also be uniquely placed to examine the relationship between COVID-19 and TB and HIV in terms of disease severity and clinical outcomes.
The TREATS-COVID study will harness support from within the existing TREATS study consortium. It is led by Zambart, a leading African research group, with European partners KNCV Tuberculosis Foundation (KNCV) and the London School of Hygiene and Tropical Medicine (LSHTM), and support from the International Union Against Tuberculosis and Lung Disease (The Union), Sheffield University, Oxford University and Delft Imaging.
The TREATS (grant number RIA2016S-1632-TREATS) and TREATS-COVID (grant number RIA2020EF-3004-TREATS COVID) studies are funded by the European & Developing Countries Clinical Trials Partnership (EDCTP), which is supported by the European Union.