Key Points:
- The University of Zimbabwe Clinical Trials Research Centre (UZ-CTRC) has initiated a research program to develop treatment regimens protecting families of multi-drug resistant tuberculosis patients.
- Zimbabwe is listed among the top ten countries globally with high rates of TB and HIV co-infection, as well as multi-drug resistant TB.
- The research aims to find effective TB preventive therapies for contacts of multi-drug resistant TB patients, particularly focusing on vulnerable groups such as children under five and those with underlying conditions like HIV.
- According to the WHO Global TB Report of 2022, Zimbabwe notified 232 drug resistant TB cases to the TB Programme in 2021, potentially affecting around 928 contacts.
- This program is part of a broader effort to address the challenges of drug-resistant TB, which accounts for about one-third of all antimicrobial resistance deaths worldwide.
- The research builds on UZ-CTRC's previous successful studies, which have contributed to shortening TB treatment regimens from nine months to four months.
The University of Zimbabwe Clinical Trials Research Centre (UZ-CTRC) has launched a groundbreaking research program aimed at developing treatment regimens to protect families of people with multi-drug resistant tuberculosis (MDR-TB). This initiative comes at a critical time, as Zimbabwe grapples with high rates of TB and HIV co-infection, as well as increasing cases of drug-resistant TB.
The TB Challenge in Zimbabwe
Zimbabwe finds itself among the top ten countries globally with high rates of TB and HIV co-infection, as well as multi-drug resistant TB. This convergence of health issues presents a complex challenge for the country’s healthcare system and researchers alike.
Drug-resistant tuberculosis, a form of antimicrobial resistance, poses significant challenges in treatment and has led to increased mortality rates. According to the World Health Organization’s Global TB Report of 2022, Zimbabwe notified 232 drug resistant TB cases to the TB Programme in 2021. This figure potentially translates to approximately 928 contacts who could be at risk of infection.
Globally, the impact of drug-resistant TB is severe. Deaths from drug-resistant tuberculosis account for about one-third of all antimicrobial resistance deaths worldwide. In 2020 alone, over 150,000 cases of resistant strains were detected globally, underscoring the urgent need for innovative solutions.
The UZ-CTRC Research Program
The UZ-CTRC research program, supported by Advancing Clinical Therapeutics Globally (formerly the AIDS Clinical Trials Group), represents a concerted effort to address this critical health issue. The program is recruiting contacts of multi-drug resistant TB patients for clinical trials, aiming to find the most effective TB preventive therapies that can prevent the spread of multi-drug resistant TB within families and communities.
Mr. Stanford Chimutimunzeve, a UZ-CTRC community advisory board member, emphasizes the importance of this research: “The UZ-CTRC is conducting research to try and control multi-drug resistant TB and to protect contacts of those patients with multi-drug resistant TB. Our job is to identify people who have multi-drug resistant TB so that they can join the programme, which is currently running.”
The research is particularly focused on protecting vulnerable groups, such as children under the age of five and individuals with underlying conditions like HIV, who are at higher risk of TB infection and more severe disease outcomes. “Families where we find these multi-drug resistant TB patients usually have children under the age of five who are vulnerable to TB infections and others with underlying conditions like HIV who are also vulnerable. They need to be protected because the severity of multi-drug resistant TB is worse than that of pulmonary TB,” Chimutimunzeve explains.
Challenges and Innovative Approaches:
While the potential impact of this research is significant, the program faces several challenges, particularly in patient recruitment and engagement. TB survivor and health promoter Ms. Amanda Sambadzai notes that stigma and discrimination have led many patients to avoid clinics, necessitating new approaches to treatment and care.
“Multi-drug resistant TB patients used to come to the clinics for their medications but they faced a lot of stigma and discrimination so it was decided that we should do home visits for them. They now get treatment from home and when we go for counselling sessions we do it in their homes to protect them,” Sambadzai explains.
This shift towards home-based care and counseling represents an innovative approach to TB treatment and management, one that could have implications beyond the scope of this research program. By bringing care directly to patients, the program not only addresses issues of stigma but also potentially improves treatment adherence and patient outcomes.
Building on Past Successes
The current research program builds on UZ-CTRC’s track record of successful TB research. Previous studies conducted by the center have led to significant advancements in TB treatment, including the shortening of treatment regimens from nine months to four months. This reduction in treatment duration has the potential to improve patient adherence and reduce the economic burden of prolonged treatment on both patients and the healthcare system.
Chimutimunzeve highlights the importance of these past successes: “UZ-CTRC has conducted many research programmes on TB that have been successful. It was through their research that we saw the shortening of TB treatment regimens from nine months to four months. One of the reasons that was drawing us back in the treatment of TB was adherence owing to the duration of the regimens and the pill burden. When research is done to improve the life of patients it should be commended.”
Economic and Social Impact
The research program not only addresses a critical health issue but also has potential economic and social benefits. People with multi-drug resistant TB face significant economic and social costs, with only one in three accessing quality care globally. By developing more effective preventive therapies and treatment approaches, this research could help reduce these burdens on patients and their families.
Alignment with University and National Goals
This research initiative aligns closely with the broader goals of the University of Zimbabwe and the nation as a whole. Prof. Paul Mapfumo, Vice Chancellor of UZ, underscores the importance of such initiatives: “The nation of Zimbabwe wants to be a knowledge-driven and innovation-led economy. The role of universities and other higher education institutions is to be at the center of this.”
The MDR-TB research program exemplifies how the University of Zimbabwe is leveraging its research capabilities to address critical national health challenges. By focusing on innovative solutions to pressing problems, the university is contributing directly to Zimbabwe’s vision of becoming a knowledge-driven economy.
A significant step forward in the fight against drug-resistant tuberculosis
The launch of this research program by the University of Zimbabwe Clinical Trials Research Centre marks a significant step forward in the fight against drug-resistant tuberculosis. By focusing on protecting the most vulnerable populations and addressing the challenges of stigma and treatment adherence, this research has the potential to transform TB prevention and treatment not just in Zimbabwe, but globally.
As the program progresses, its outcomes could have far-reaching implications for public health policy, treatment protocols, and community engagement strategies. The success of this initiative could serve as a model for other countries grappling with similar challenges, further cementing the University of Zimbabwe’s role as a leader in innovative health research.
For more insights on the University of Zimbabwe’s transformation and focus on innovation, read the full interview with Prof Paul Mapfumo here: https://africalive.net/interview/prof-paul-mapfumo/
