Project: Translation research into policy and practice: Scaling up Evidence Based Multiple focus Integrated Intensified TB Screening to End TB (EXIT-TB) in the East African region

Acronym	EXIT-TB (Reference Number: CSA2016S-1608)
Duration	01/04/2018 - 31/03/2021
Project Topic	Tuberculosis (TB) remains a major cause of morbidity and mortality especially in sub-Saharan Africa. This high burden is mainly attributed to low case detection and delayed diagnosis. Recently, country surveys have showed unacceptable high prevalence of confirmed TB even among those with a low duration cough and more than 50% of those with prevalent bacteriologically confirmed pulmonary TB do not report symptoms that correspond to presumptive TB. Furthermore, there is an increase in incidence ofsmear negative pulmonary TB patients who can serve as source of infection. In view of the foregoing, aggressive control measures are essential.We are seeking to accelerate the translation of research into policy and practice through Evidence Based Multiple focus Integrated Intensified TB Screening package (EXIT-TB). The EXIT-TB package will involve intensified passive TB case finding (screening all patients at the Outpatient department (OPD) who passively report any cough irrespective of duration); integrating TB case finding activities into reproductive and child health clinics (RCH) and diabetics clinics; screening for TB irrespective of symptoms among HIV/AIDS infected individuals with advanced diseases attending Care and Treatment Centres (CTC), and targeted contact tracing for all TB patients with child household members.The EXIT-TB package is a set of interventions proved to be working under research conditions. A publication from Ethiopia and South Africa and the findings published in BMC and PHA (IUTLD) journals showed significant number of bacteriologically confirmed TB among patients attending OPD and RCH with a cough of less than two weeks. Findings published in the Lancet suggest that ifsputum is requested irrespective of symptoms, 13% of patients in this group will be diagnosed with TB, of which only 38% of the diagnosed TB patients will have a cough.Given the proven scientific evidence, it is believed that, the EXIT-TB package will increase TB case detection, reduce TB diagnostic and treatment delays and increase number of TB patients put into TB care including women and children. The implementation research goals will be achieved through 4 essential steps, namely: 1) translation, 2) dissemination, 3) adoption/diffusion of innovative intervention and 4) effective implementation. Sputum and stool and test will be collected for TB using GeneXpert or sputum smear microscopy and culture (as a gold standard) and house hold contact tracing targeting children with household members with TB will be conducted. In addition, children will be screened using TB screening tool and other confirmatory tests.
Network	EDCTP2
Call	Strategic actions supporting health systems/services optimisation research capacities in cooperation with development assistance initiatives

Project partner

Number	Name	Role	Country
1	National Institute for Medical Research - Tanzania	Coordinator	Tanzania
3	Addis Ababa University	Partner	Ethiopia
4	Infectious Diseases Institute Limited	Partner	Uganda
5	Kenya Medical Research Institute	Partner	Kenya
6	Liverpool School of Tropical Medicine	Partner	United Kingdom
7	Makerere University	Partner	Uganda
8	Ministry of Health - Uganda	Partner	Uganda
9	Ministry of Health, Community Development, Gender, Elderly and Children	Partner	Tanzania
10	The Good Samaritan Foundation, Kilimanjaro Christian Medical Centre	Partner	Tanzania
11	University College London	Partner	United Kingdom
12	University of Bergen	Partner	Norway
13	University of Khartoum	Partner	South Sudan