SA groundbreaking study transforms TB treatment policy globally

A groundbreaking initiative, BEAT-Tuberculosis, has become the world’s first programme in the battle against drug-resistant tuberculosis (DR-TB) for all population groups, influencing the international TB treatment policy of the World Health Organisation (WHO).

Effective shortened treatment

The principal investigator leading this study, Dr Francesca Conradie, explained that the study’s success in demonstrating the safety and effectiveness of the new short oral regimen in these key populations marks a pivotal step toward a more comprehensive and equitable healthcare strategy for TB.

“The BEAT-Tuberculosis study represents a groundbreaking approach in the fight against tuberculosis, particularly with its inclusive research methodology.

“By incorporating pregnant women and children into the clinical trials, the study has expanded the understanding of TB treatment’s efficacy and safety across broader demographics,” said Conradie.

The primary aim was to evaluate the effectiveness and safety of a novel shortened treatment regimen for DR-TB compared with the established standard of care.

The standard treatment consisted of a regimen of seven drugs administered over a minimum of nine months, in comparison to a regimen of four to five medications, which included newer agents like bedaquiline and delamanid, and was administered over only six months.

A study six years in the making

The BEAT-Tuberculosis clinical study was conducted at the Clinical HIV Research Unit (CHRU) Isango Lethemba TB Research Unit in the Eastern Cape and KwaZulu-Natal over the past six years.

The study began in 2019 and despite the formidable challenges posed by COVID-19, over 400 participants were enrolled across study sites in both provinces.

The study’s other objective was to build research capacity for DR-TB in the Eastern Cape and KwaZulu-Natal, through community engagement and training healthcare personnel in clinical research methodologies for TB treatment.

“This collaborative effort received crucial support from the National and Provincial Departments of Health that provided essential medication and laboratory infrastructure for safety and efficacy assessments,” said Conradie.

The local research study was made possible by the collaboration of the National Department of Health, funded by the United States Agency for International Development (USAID) and executed by the University of the Witwatersrand.

Local study with global impact

The results from the study have influenced the WHO policy on the treatment of TB, and at the same time put the Global South centre stage for driving improved treatment for all.

National Department of Health’s Chief Director of TB Control and Management, Professor Norbert Ndjeka, said that in 2022, an estimated 280 000 people developed TB in South Africa, while 54 000 died from the disease.

TB remains a threat to global public health and the second leading cause of death in South Africa.

“With this concerning observation in mind, we acknowledge the BEAT-Tuberculosis project as an exemplary and concerted effort to advance TB treatment and research capabilities, poised to bring about transformative changes in RR-TB management worldwide.

“While the study was originally intended to inform local treatment guidelines, the results are now set to benefit patients everywhere.”

USAID Southern Africa Mission Director, Leslie Marbury, believes that the National Department of Health and his organisation have improved TB patient care worldwide.

Marbury said the organisation celebrates the 400 participants who made this trial possible and brought the world closer to ending TB.

“We also thank all BEAT-Tuberculosis stakeholders, including the National Department of Health, the Eastern Cape and KwaZulu-Natal Health Departments, and local medical facilities, for their dedication and commitment to this globally recognised study,” she added.

TB symptoms

The most common symptoms of TB are a cough that lasts more than two weeks, weight loss, drenching night sweats and a fever.

Anyone with these symptoms is urged to go to their local clinic.

“You will be asked to produce sputum or phlegm which will be tested for TB. If the test is positive, the correct treatment will be started.” – SAnews.go.za