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Challenge Cluster for Post-TB Lung Health in Children in sub-Sahara Africa.

撒哈拉以南非洲儿童结核病后肺部健康挑战集群。

基本信息

批准号：
EP/T024097/1
负责人：
Toyin Togun
金额：
$ 15.37万
依托单位：
London School of Hygiene & Tropical Medicine
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2020
资助国家：
英国
起止时间：
2020 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=EP%2FT024097%2F1
关键词：
Challenge Cluster Post TB Lung

项目摘要

In 2017, there were an estimated 10 million new cases of tuberculosis (TB) disease globally, and 1.6 million peoples died from TB. This makes TB the leading cause of death from a single infectious agent worldwide. However, the majority of the TB cases and deaths occur in low- and middle-income countries (LMICs), where difficulties in diagnosis and treatment contribute to poor outcomes in TB patients. While global TB reports are based on estimates of patients who die either before or during TB treatment, there is now a growing body of evidence suggesting that patients cured or successfully treated for TB have persistent health impairment, and a relatively higher morbidity and mortality after treatment, than the general population.These evidence of potentially elevated risk of adverse health consequences after TB treatment in the published literature are exclusively derived from adult data. While pulmonary TB (PTB) accounts for at least 80% of the 1 million TB cases that occur in children aged less than 15 years, there are currently no published data about adverse health consequences and/or long-term impact of pulmonary TB, including changes in the lung function, in children and adolescents who have completed TB treatment in neither high- nor low-income countries, where the burden of TB disease is particularly high. Achieving the ambitious goals of the WHO End TB Strategy will require that attention is paid not only to poor outcomes before or during TB treatment, but also to morbidity and mortality after TB treatment. In this regard, "Life and Well-being after Tuberculosis" has now being adopted as one of the two overall priority themes in the strategic plan of the World TB Union's Lung Health Department.With this Challenge Cluster proposal, we will bring together two multi-country collaborative projects, supported by MRC GCRF Foundation Awards, with specific expertise in childhood TB and in lung health in Africa, including the Reach for Kids Africa (R4KA) and Lung Health in Africa across the Life Course (LuLi). The GCRF-funded partners will additionally link with partners in national TB programs from across sub-Sahara Africa and members of the TB-affected communities, underpinned by key regional and international collaborative research networks, including the Pan African Thoracic Society (PATS), International Union Against TB and Lung Disease (The Union), West African Paediatric TB Network (WApTBNet) and TB PROOF - a leading TB advocacy organisation in South Africa. We will begin advocacy and research toward increasing the awareness of post-TB lung health with a focus on children among health care workers, TB-affected communities and policy makers from across sub-Sahara Africa. We will also develop the capacity and confidence of health care workers to evaluate lung function in children who have completed treatment for PTB, and begin to generate data that will accurately describe the prevalence of lung function impairment attributable to TB in children in sub-Sahara Africa.Our proposal will deliver on the following specific objectives within 12 months of the project activities: (i) organise a workshop on post-TB lung health in children in LMICs for paediatricians drawn from our proposed pan-Africa GCRF Challenge Cluster collaborative partnerships; (ii) train paediatricians in sub-Sahara Africa on paediatric spirometry, in order to evaluate lung function in children who have completed TB treatment; (iii) organise a participatory workshop for former TB patients and TB-affected families in West Africa, using exploratory and descriptive qualitative research approaches, in relation to household-incurred costs and strategies adopted for coping with persistent health impairments due to TB; and (iv) set up a multi-site pan-African platform for the establishment of prospective cohorts in the future, for clinical, epidemiological and applied health research.

2017年，全球估计有1000万新发结核病病例，160万人死于结核病。这使得结核病成为全球单一传染性病原体导致死亡的主要原因。然而，大多数结核病病例和死亡发生在低收入和中等收入国家，这些国家的诊断和治疗困难导致结核病患者的预后不良。虽然全球结核病报告是基于结核病治疗前或治疗期间死亡的患者的估计数，但现在有越来越多的证据表明，治愈或成功治疗结核病的患者存在持续的健康损害，治疗后的发病率和死亡率相对较高，在已发表的文献中，这些关于结核病治疗后不良健康后果的潜在风险升高的证据是完全来自成人数据。虽然在15岁以下儿童中发生的100万例结核病病例中，肺结核至少占80%，但目前尚无关于肺结核对已完成结核病治疗的儿童和青少年的不良健康后果和/或长期影响（包括肺功能变化）的已发表数据，无论是在高收入还是低收入国家，那里的结核病负担特别高。实现世卫组织终止结核病战略的宏伟目标将要求不仅关注结核病治疗前或治疗期间的不良结果，而且关注结核病治疗后的发病率和死亡率。在这方面，“结核病后的生活和福祉”现已被列为世界结核病联盟肺部健康部战略计划的两个总体优先主题之一。通过这一挑战集群提案，我们将汇集两个多国合作项目，由MRC GCRF基金会奖支持，在非洲儿童结核病和肺部健康方面具有专门知识，包括Reach for Kids Africa（R4KA）和Lung Health in Africa across the Life Course（LuLi）。GCRF资助的合作伙伴还将与撒哈拉以南非洲国家结核病项目的合作伙伴以及受结核病影响社区的成员建立联系，并得到主要区域和国际合作研究网络的支持，包括泛非胸科协会（PATS）、国际结核病和肺部疾病防治联盟（联盟），西非儿科结核病网络（WApTBNet）和TB PROOF -南非领先的结核病倡导组织。我们将开始宣传和研究，以提高对结核病后肺部健康的认识，重点是撒哈拉以南非洲地区的卫生保健工作者、结核病影响社区和政策制定者中的儿童。我们还将培养卫生保健工作者的能力和信心，以评估已完成肺结核治疗的儿童的肺功能，并开始生成数据，准确描述撒哈拉以南非洲儿童肺结核所致肺功能损害的患病率。我们的提案将在项目活动的12个月内实现以下具体目标：㈠为来自我们拟议的泛非洲全球合作框架挑战集群合作伙伴关系的儿科医生组织一次关于中低收入国家儿童结核病后肺部健康的讲习班; ㈡对撒哈拉以南非洲的儿科医生进行儿科肺量计测定法培训，以评估完成结核病治疗的儿童的肺功能; ㈢利用探索性和描述性定性研究方法，为西非前结核病患者和受结核病影响的家庭组织一次参与性讲习班，内容涉及家庭承担的费用和为应对结核病造成的持续健康损害而采取的战略;以及㈣建立一个多地点泛非平台，以便今后建立前瞻性队列，进行临床、流行病学和应用卫生研究。