Technology supported systems for rapid impact on TB control

Lead Research Organisation: University of the Witwatersrand

Abstract

Delivery of diagnostic services that serve the population well depends upon the availability of high quality diagnostic tests and of laboratory systems that are able to prioritise efforts in regions of particular need and respond to changes in the distribution of that need. South Africa has pioneered widespread introduction of a new test for tuberculosis (TB) called Xpert MTB/RIF which runs on a platform called Genexpert that has capability both for connectivity to a central laboratory facility and for testing for things other than just TB. This means that the National Health Laboratory Service is able to identify where there are increases in people being diagnosed with TB, and potentially also follow trends in other infectious diseases such as HIV. In addition, this network provides the opportunity to test the performance of new and improved tests for infectious diseases, including TB, with the ultimate goal of improving patient care.

Technical Summary

The National Priority Program (NPP) of the National Health Laboratory Service was formalized in 2010 to address the National Department of Health’s (NDoH) need to provide increased access to patient testing to enhance care programs, with a focus on HIV and TB and other opportunistic infections. Strength of this program is its national footprint of laboratory analyzers that are all interfaced via a laboratory information system (LIS). This data is reviewed centrally and provides the backbone to monitoring and evaluation of NDoH treatment programs. The LIS and other data connectivity tools, provides the basis for identifying trends in disease prevalence, “hot spots” of transmission, the impact of interventions and regions of poor service coverage. In particular this group’s implementation model for pulmonary TB testing using the GeneXpert platform has become a globally accepted approach. These implementation models require refining to improve current practice (especially for MDR/XDR TB diagnosis), modification with the introduction of the more sensitive GeneXpert Ultra test and integration with HIV through exploration of the polyvalent capabilities of the GeneXpert platform and expansion to vulnerable populations.

The anticipated outcomes of the three year project and collaboration are to implement the
mapping systems to impact on patient care and deliver models that will improve patient care and linkage to treatment as well as reduce costs while improving and integrating service delivery.

Three milestones have been identified: (i) primarily to deliver system mapping tools (a national dashboard for monitoring and evaluation; a real-time operational dashboard for improved laboratory service delivery; a novel real-time molecular epidemiology dashboard to target interventions); and secondarily (ii) to streamline diagnostic algorithms to increase rapid TB detection, drug resistance and reduce program costs; and (iii) to integrate TB and HIV service delivery using polyvalent diagnostic testing platforms to meet sustainable development goals.

Four goals have been identified for this study in order to achieve the milestones
1 - to optimize connectivity platforms to ensure optimal reporting of
relevant TB disease indicators and optimize “real-time” laboratory quality indicators and thereby improve TB control.

2 - to evaluate new diagnostics for TB and MDRTB to improve
patient diagnosis and develop cost-effective laboratory diagnostic and treatment algorithms.

3 - to further evaluate these diagnostic platforms for polyvalent
capabilities to integrate and optimize TB and HIV patient care and service.

4 - to develop and propose policy using the connectivity mapping tools to optimize current services and models of new and integrated diagnostics to improve services.
 
Description Africa CDC Forum, Consultative Meeting of the Africa Collaborative to Advance Diagnostics to Meet the Continent's Health Agenda. Addis Ababa, Ethiopia. 24-25 September 2019
Geographic Reach Africa 
Policy Influence Type Participation in a advisory committee
 
Description Contribution to "Missing TB cases strategic plan"
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
 
Description Costing of all TB laboratory tests: recommendations made to NHLS/NDoH, with particular focus on new testing assays and platforms
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
 
Description Drafting of a Point-of-Care document for the South African National Department of Health (under revision)
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
 
Description Implementation of Point of Care policy, NDOH (published 2019)
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description National Support Team for TB Diagnostics in China
Geographic Reach Asia 
Policy Influence Type Participation in a advisory committee
 
Description Recommendations made to NDoH regarding Xpert MTB/RIF Ultra implementation
Geographic Reach Africa 
Policy Influence Type Participation in a advisory committee
Impact After 7 years of the use of Molecular TB diagnostics, Xpert MTB/RIF, this diagnostic has been shown to impact on reduction of mortality, and increased access to care. The more sensitive test, Xpert Ultra, is expected to have similar impact, and already has identified 2% more cases of TB in South Africa's national program
 
Description TB Think Tank Annual Meeting: 26 November 2018
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Title Operational Dashboard for GeneXpert TB Country Data 
Description Two TB dashboards were developed to support the National Priority Program in management of the South African TB program. Extensive data mining projects are ongoing 
Type Of Material Data handling & control 
Year Produced 2018 
Provided To Others? No  
Impact This dashboard will be transitioned and hosted by the NHLS. National TB and Laboratory program managers will be able to access the data, and better manage relevant programmes. The overall impact is improved TB control. 
 
Description Cepheid HIV-1 Viral Load evaluation on 'off-label' specimens 
Organisation Cepheid
Country United States 
Sector Private 
PI Contribution Optimisation of off-label specimen testing has been optimised. A clinical trial is approved to commence on 1 April 2017.
Collaborator Contribution Supply of Xpert HIV-1 VL cartridges and instrument for clinic for study duration, with the aim of further integrating HIV-TB diagnostics.
Impact Multiple iterations of whole blood testing have been tested. Data was presented in 2017, but current data is under confidentiality as processes are improved. Further testing is expected in late 2019. Conference Abstracts Noble L, Stevens W, Scott L. Xpert HIV-1 Viral Load: Beyond Plasma. International AIDS Society (IAS 2017) Conference Cepheid Satellite Session: Integrating Diagnostic Services at Point-of-Care. Paris, France. 23-26 July 2017. Noble L, Scott L, Stevens W. Xpert® HIV-1 Viral Load: Preliminary Findings on Fingerstick WB & DBS Testing. SA AIDS Conference, Cepheid Satellite Session. 13-15 June 2017. Durban, South Africa. Noble L, Stevens W, Scott L. Laboratory Evaluation of the Xpert HIV-1 Viral Load assay using low volume plasma specimens. 11th Interest Meeting. 15-19 May 2017. Lilongwe, Malawi.
Start Year 2016
 
Description Comparison of the Abbott RealTime MTB and GeneXpert MTB/RIF assays for the diagnosis of tuberculosis for improved patient care. 
Organisation Abbott
Department Abbott Diagnostics
Country United States 
Sector Private 
PI Contribution Study management, provision of specimens, provisional data analysis.
Collaborator Contribution Instruments, reagents and training.
Impact This study was completed in early 2018 and the platforms moved into the FIND multi-site, multi-platform study. Data was disseminated through publication and presentation. Manuscript Berhanu RH, David A, da Silva P, Shearer K, Sanne I, Stevens W, Scott L. Performance of Xpert MTB/RIF, Xpert Ultra, and Abbott Real Time MTB for the diagnosis of pulmonary tuberculosis in a high HIV burden setting. Journal of Clinical Microbiology. Published online 10 October 2018. DOI: 10.1128/JCM.00560-18. PMID: 30305387. IMPACT FACTOR: 4.1. Conference abstract Anura David, Lesley Scott, Pedro Da Silva, Wendy Stevens. Performance of RealTime MTB RIF/INH Resistance and Genotype MTBDRplus V2 assays for identification of drug resistant Mycobacterium tuberculosis complex (MTBC) using isolates. 49th Union World Conference on Lung Health. The Hague, The Netherlands. 24-27 October 2018. Anura David, Lesley Scott, Ribkha Berhanu, Andrew Black, Pedro da Silva, Lyndel Govender, Wendy Stevens. Abbott RT-MTB and Abbott RT-MTB/INH-RIF assay: Experience in Johannesburg, SA. Abbott Symposium. 5th South African Tuberculosis Conference. Durban, South Africa. 12-15 June 2018.
Start Year 2016
 
Description Comparison of the Abbott RealTime MTB and GeneXpert MTB/RIF assays for the diagnosis of tuberculosis for improved patient care. 
Organisation Cepheid
Country United States 
Sector Private 
PI Contribution Study management, provision of specimens, provisional data analysis.
Collaborator Contribution Instruments, reagents and training.
Impact This study was completed in early 2018 and the platforms moved into the FIND multi-site, multi-platform study. Data was disseminated through publication and presentation. Manuscript Berhanu RH, David A, da Silva P, Shearer K, Sanne I, Stevens W, Scott L. Performance of Xpert MTB/RIF, Xpert Ultra, and Abbott Real Time MTB for the diagnosis of pulmonary tuberculosis in a high HIV burden setting. Journal of Clinical Microbiology. Published online 10 October 2018. DOI: 10.1128/JCM.00560-18. PMID: 30305387. IMPACT FACTOR: 4.1. Conference abstract Anura David, Lesley Scott, Pedro Da Silva, Wendy Stevens. Performance of RealTime MTB RIF/INH Resistance and Genotype MTBDRplus V2 assays for identification of drug resistant Mycobacterium tuberculosis complex (MTBC) using isolates. 49th Union World Conference on Lung Health. The Hague, The Netherlands. 24-27 October 2018. Anura David, Lesley Scott, Ribkha Berhanu, Andrew Black, Pedro da Silva, Lyndel Govender, Wendy Stevens. Abbott RT-MTB and Abbott RT-MTB/INH-RIF assay: Experience in Johannesburg, SA. Abbott Symposium. 5th South African Tuberculosis Conference. Durban, South Africa. 12-15 June 2018.
Start Year 2016
 
Description Cost model for simplified algorithms, including Xpert MTB/RIF Ultra 
Organisation Health Economics and Epidemiology Research Office
Country South Africa 
Sector Charity/Non Profit 
PI Contribution Expert insight into assumptions backed by data and scientific knowledge
Collaborator Contribution Technical expertise on costing and modeling
Impact Internal report and findings contributed to the National Priority Programme transitioning to the Xpert MTB/RIF Ultra cartridge.
Start Year 2017
 
Description Evaluation of the automated Fluorotype tuberculosis assay for TB drug resistance testing (first and second-line) 
Organisation Hain Lifescience GmbH
Country Germany 
Sector Private 
PI Contribution Safety testing, provision of specimens; study is ongoing, but will require data analysis at a later stage. Software has been upgraded based on early testing. Clinical evaluation now complete.
Collaborator Contribution Provision of instrument. Software upgrades based on early data analysis. Training of scientists.
Impact This study was completed in 2018 and the technology was introduced into the FIND multi-site, multi-platform evaluation, with testing ongoing. Conference Abstract: Anura David, Lesley Scott, Pedro Da Silva, Wendy Stevens. Performance of RealTime MTB RIF/INH Resistance and Genotype MTBDRplus V2 assays for identification of drug resistant Mycobacterium tuberculosis complex (MTBC) using isolates. 49th Union World Conference on Lung Health. The Hague, The Netherlands. 24-27 October 2018.
Start Year 2016
 
Description Expansion of HIV Viral Load Monitoring at Point of Care (Xpert HIV-1 VL) 
Organisation University of Edinburgh
Department Global Fund
Country United Kingdom 
Sector Academic/University 
PI Contribution The Xpert HIV viral load assay evaluation showed that viral load monitoring can be performed in decentralized laboratories and extended VL testing for patient monitoring is being trialed at multiple remote clinics. Training manuals were prepared for staff training. In addition, a point of care policy document was prepared in collaboration with the NHLS and the National Department of Health and is currently under revision.
Collaborator Contribution Expert opinion, financial.
Impact Provisional Point of Care Policy Document. Training materials for staff, which will ultimately be distributed nationally. CROI 2020 abstract 01090 - accepted: Sarah Girdwood, Thomas Crompton, Wendy Stevens, Brooke E. Nichols. Cost-effectiveness of point of care viral load adoption strategies in South Africa.
Start Year 2016
 
Description FIND multi-centre evaluation of the Xpert MTB/RIF Ultra for TB diagnosis. 
Organisation Foundation for Innovative New Diagnostics (FIND)
Country Switzerland 
Sector Charity/Non Profit 
PI Contribution As part of a 10-country study to evaluate the more sensitive Xpert Ultra sputum test for TB and show non-inferiority to existing Xpert MTB/RIF TB test, two clinical sites were established (Hillbrow and Thembaletu) and laboratory testing was performed at a dedicated clinical trials laboratory (CLS). This will result in improved diagnostics for TB care.
Collaborator Contribution Policy for improved patient care.
Impact WHO policy and recommendations completed. The Xpert MTB/RIF Ultra assay has now been implemented using both pulmonary and extra pulmonary specimens (internal country evaluation) across the National Health Laboratory Service which services 80% of South Africa. Manuscript: Dorman SE, Schumacher SG, Alland D, Nabeta P, Armstrong DT, King B, Hall SL, Chakravorty S, Cirillo DM, Tukvadze N, Bablishvili N, Stevens W, Scott L, Rodrigues C, Kazi MI, Joloba M, Nakiyingi L, Nicol MP, Ghebrekristos Y, Anyango I, Murithi W, Dietze R, Lyrio Peres R, Skrahina A, Auchynka V, Chopra KK, Hanif M, Liu X, Yuan X, Boehme CC, Ellner JJ, Denkinger CM. (2018) Xpert MTB/RIF Ultra for detection of Mycobacterium tuberculosis and rifampicin resistance: a prospective multicentre diagnostic accuracy study. The Lancet Infectious Diseases 18(1):76-84. Published online 30 November 2017. DOI: 10.1016/S1473-3099(17)30691-6. PMID: 29198911. IMPACT FACTOR: 25.2. Berhanu RH, David A, da Silva P, Shearer K, Sanne I, Stevens W, Scott L. Performance of Xpert MTB/RIF, Xpert Ultra, and Abbott Real Time MTB for the diagnosis of pulmonary tuberculosis in a high HIV burden setting. Journal of Clinical Microbiology. Published online 10 October 2018. DOI: 10.1128/JCM.00560-18. PMID: 30305387. IMPACT FACTOR: 4.1. Conference Abstracts: Pedro da Silva, Lesley Scott, Anura David, Wendy Stevens. Use of Xpert MTB/RIF and Xpert MTB/RIF Ultra for testing of non-pulmonary specimen types in South Africa. Cepheid Symposium, 5th South African Tuberculosis Conference. Durban, South Africa. 12-15 June 2018.
Start Year 2016
 
Description Installation of the Cepheid C360 dashboard on National Priority Program field-based instruments 
Organisation Cepheid
Country United States 
Sector Private 
PI Contribution Capabilities for medical informatics using the laboratory information system (LIS) are still being investigated and ways forward determined, but the C360 dashboard installation on the National Priority Program instruments in the field. Data management and analysis.
Collaborator Contribution Provision of the C360 dashboard.
Impact In progress
Start Year 2016
 
Description Roche Prototype Molecular Test Evaluation 
Organisation F. Hoffmann-La Roche AG
Country Global 
Sector Private 
PI Contribution Project management, evaluation of instrument, data management.Two sites were established with Dr Neil Martinson in Soweto and Klerksdorp for specimen colelction. The technology is still at the early developmental stage.
Collaborator Contribution Provision of instrument, reagents and training.
Impact This study was continued into a full clinical trial, with data disseminated at conferences and a manuscript pending. The technology is now under evaluation as part of the FIND multi-site, multi-platform study, which commenced in 2018. Manuscript: Anura David, Puleng Marokane, Robert W. Coombs, Wendy Stevens, Lesley Scott. Global Performance of GeneXpert (Xpert MTB/RIF, Cepheid) using standardized verification and external quality assessment (EQA) material. Under submission. Conference Abstracts Anura David, Lesley Scott, Wendy Stevens et al. Evaluation of a prototype cobas®MTB assay for use on the cobas® 6800/8800 Systems for the detection of Mycobacterium tuberculosis in a high burden HIV patient population 22nd International AIDS Conference (AIDS 2018). Amsterdam, The Netherlands. 23-27 July 2018. (Poster-oral. Winner of 1/5 IAS TB/HIV Research Prizes)
Start Year 2016
 
Title Cepheid HIV-1 Viral Load Evaluation on 'off-label' specimens 
Description The GeneXpert instruments are widely available in South Africa for tuberculosis diagnostics and clinical trials of the HIV-1 assays at point-of-care are ongoing. We are testing 'off-label' for both point-of-care and centralised laboratory testing to further increase the usability of the instrument for polyvalent HIV-TB testing. 
Type Diagnostic Tool - Non-Imaging
Current Stage Of Development Early clinical assessment
Year Development Stage Completed 2016
Development Status Under active development/distribution
Impact In progress. 
 
Title FIND multi-country evaluation of the Xpert MTB/RIF Ultra 
Description The evaluation of the new Xpert Ultra TB test in collaboration with FIND is complete and preliminary data analysis shows the assay will be applicable to South Africa's TB program and increase detection of presumptive TB cases. 
Type Diagnostic Tool - Non-Imaging
Current Stage Of Development Market authorisation
Year Development Stage Completed 2016
Development Status Under active development/distribution
Clinical Trial? Yes
UKCRN/ISCTN Identifier PO-7210
Impact Not applicable 
 
Description 49th Union World Conference on Lung Health. The Hague, The Netherlands. 24-27 October 2018. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The talks presented at this high-level meeting described the current situation in South Africa with regards to tuberculosis drug resistance, including diagnostic options, treatment options and impact on patient management and mortality. This knowledge dissemination is important for national and global policy and improved patient management.

1.The TB care cascade for rifampicin resistant TB: Adherence to the South African department of health algorithm for the management of MDR-TB patients.
2. Number of effective drugs in the short-course multidrug resistant tuberculosis regimen according to standard-of-case and whole genome sequencing.
3. Real-life impact of the implementation of Xpert MTB/RIF on patient management, time to treatment initiation and mortality among people diagnosed with rifampicin resistant TB.
4. Performance of RealTime MTB RIF/INH Resistance and Genotype MTBDRplus V2 assays for identification of drug resistant Mycobacterium tuberculosis complex (MTBC) using isolates.
Year(s) Of Engagement Activity 2018
URL https://thehague.worldlunghealth.org/
 
Description 5th South African Tuberculosis Conference. Durban, South Africa. 12-15 June 2018 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Diverse presentations were shared with key South African stake holders at this meeting. The outcomes of contact tracing ("Changing strategy from door to door to contact tracing increases TB detection marginally in South Africa") and centralized monitoring ("Diagnostic algorithm and electronic dashboards, implications for monitoring transmission") highlighted the options for finding the "missing TB millions", while the other presentations described technology options. The evaluation of the Abbott tuberculosis assays ("Abbott RT-MTB and Abbott RT-MTB/INH-RIF assay: Experience in Johannesburg, SA.") was well-received and the technology has entered into a multi-platform head-to-head evaluation. This will improve laboratory testing options, provide evidence for laboratory integration possibilities and increase competition in the tuberculosis testing market. The evaluation of extra-pulmonary specimens on the GeneXpert platform ("Use of Xpert MTB/RIF and Xpert MTB/RIF Ultra for testing of non-pulmonary specimen types in South Africa") has already led to impact as this is now included in the national tuberculosis testing algorithm.
Year(s) Of Engagement Activity 2018
URL http://www.tbconference.co.za
 
Description ACTG Annual Meeting: Future Directions Session 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact The presentation entitled: "Update on Line Probe Assay External Quality Assessment" disseminated knowledge on the progress of this product, now in the pilot phase. It will ultimately ensure quality assessment of laboratories performing the HAIN MTBDRplus assay to determine tuberculosis drug resistance patterns and there was great interest from the audience in the program.
Year(s) Of Engagement Activity 2016
 
Description AIDS 2016: TB pre-meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact The discussion around this presentation: "Access to second-line treatment for children diagnosed with Rifampicin-resistant tuberculosis in South Africa: a national retrospective cohort study" was lively and informative. Clinical staff dealing with the treatment of tuberculosis were particularly interested in options to improve access to the treatment for children in resource limited environments.
Year(s) Of Engagement Activity 2016
 
Description AIDS 2018 - Roche TB 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The post-oral, which was a prize winner, described the new cobas MTB/MTBDR/MIA assay evaluation to a wide audience. This led to a larger multi-platform evaluation (ongoing) to determine the performance of a number of molecular tuberculosis diagnostics. The impact of increasing diagnostic options is improved patient diagnosis (with the ultimate aim of decreased tuberculosis transmission), integrated laboratory systems (with different assays being used on single platforms, which can be selected based on laboratory or country requirements) and market competition.

"Evaluation of a prototype cobas®MTB assay for use on the cobas® 6800/8800 Systems for the detection of Mycobacterium tuberculosis in a high burden HIV patient population"
Year(s) Of Engagement Activity 2018
URL https://www.aids2018.org/
 
Description Africa CDC Forum, Consultative Meeting of the Africa Collaborative to Advance Diagnostics to Meet the Continent's Health Agenda. Addis Ababa, Ethiopia. 24-25 September 2019 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Wendy Stevens presented a plenary session: The Reality of Diagnostics in Africa. This plenary was extremely well received, sparked extensive debate and discussion and multiple follow up engagements during the course of the conference. Professor Stevens has subsequently been asked to assist multiple stakeholders in optimizing their diagnostic program strategies.
Year(s) Of Engagement Activity 2019
 
Description African Society for Laboratory Medicine 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact The presentation entitled: "Improving the quality of a large scale Xpert MTB/RIF program in South Africa", enabled dissemination of knowledge to other African countries and guidance to practitioners at all levels of the healthcare system regarding the degree of quality needs around large-scale molecular testing.
Year(s) Of Engagement Activity 2016
 
Description African Society for Laboratory Medicine 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact The presentation, "GeneXpert Connectivity, experience with a Laboratory Information System and Remote Dashboard Cepheid C360" at a workshop sponsored by the SA National Priority Program ("Lessons Learnt from a large scale implementation of the Xpert MTB/RIF TB program in South Africa") provided participants with information regarding the utility of data from Xpert MTB/RIF tests and their application for monitoring and evaluation.
Year(s) Of Engagement Activity 2016
 
Description African Society for Laboratory Medicine Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact The presentation entitled: "Has the threshold of case-detection with Xpert MTB/RIF been reached in South Africa?" ensured lively debate about the program locally and across Africa.
Year(s) Of Engagement Activity 2016
 
Description African Society for Laboratory Medicine Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact The presentation entitled: "The Spectrum of Use of the Xpert MTB/RIF test in the South AfricanNational GeneXpert Program", enabled dissemination of knowledge to other African countries and generated interest regarding the previous and future directions of the Xpert MTB/RIF roll-out.
Year(s) Of Engagement Activity 2016
 
Description ICASA 2019. Kigali, Rwanda. 2-7 December 2019. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact A talk presented by Naseem Cassim titled: The costs of implementing HIV viral load point of care testing in South Africa. This aimed to share knowledge and lessons learnt with international stakeholders and interested parties to enable implementation of similar programs throughout Africa.
Year(s) Of Engagement Activity 2019
 
Description NIH/NIAID meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The talk, "Halting TB Transmission in HIV Endemic Settings Workshop" provided audience members with information on how to impact TB control in areas of high HIV co-infection.
Year(s) Of Engagement Activity 2017
 
Description SA AIDS Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact The presentation, 'Advances in molecular diagnostics for pulmonary tuberculosis: Xpert MTB/RIF, Xpert Ultra, and RealTime MTB' described the results of a study comparing three molecular tests for the detection of tuberculosis and provided audience members with detailed information on the accuracy of these tests and their likely clinical utility.
Year(s) Of Engagement Activity 2016
 
Description South African TB strategy working groups 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact A number of meetings and manuscript revisions were completed (Contribution to "Missing TB cases strategic plan", Assistance with NHLS strategic plan 2018-2021, Contribution to Global fund proposal for TB) to ensure that all persons infected with tuberculosis can be actively sought, accurately tested, treated and monitored, and to decrease the transmission of tuberculosis in South Africa.
Year(s) Of Engagement Activity 2018
 
Description TB Keystone Meeting 2018 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The talk presented, "The Potential of Rifabutin for the Treatment of Rifampicin Resistant Tuberculosis" was important to influence policy on treatment of rifampicin-resistant tuberculosis and has led to improved patient management options, with the long term impact of advancing tuberculosis control.
Year(s) Of Engagement Activity 2018
URL http://www.keystonesymposia.org/18X7
 
Description TB Think Tank 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact This annual meeting influences tuberculosis testing, treatment and tracing policy for ongoing improvement of the tuberculosis programme.
Year(s) Of Engagement Activity 2018
 
Description The 50th Union World Conference on Lung Health; 2019; Hyderabad, India. 30 October - 2 November 2019. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Lesley Scott presented a poster: Spatiotemporal analysis of Xpert MTB/RIF Ultra "trace" laboratory results from South Africa. The led to discussions and follow up engagements with multiple interested parties.
Year(s) Of Engagement Activity 2019
 
Description The 50th Union World Conference on Lung Health; Hyderabad, India. 30 October - 2 November 2019. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Pedro Da Silva presented the following: Verifying the use of Xpert MTB/RIF Ultra for diagnosing extra-pulmonary tuberculosis in South Africa at The 50th Union World Conference on Lung Health. The presentation was well received, led to debate and requests for further information from other countries aiming to use the Xpert MTB/RIF Ultra assays in their national TB programs.
Year(s) Of Engagement Activity 2019
 
Description Union Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact Presentation regarding the impact of big data analysis on TB control.
Year(s) Of Engagement Activity 2016