An analysis of randomized controlled trials of tuberculosis prophylaxis and treatment in Africa

Tags: Poster
Abrams A1, Kredo T1
1South African Cochrane Centre, South Africa

Background: Africa is severely affected by tuberculosis (TB). In 2011 sub-Saharan Africa carried the greatest proportion of new cases with over 260 cases per 100 000 population. Completed, ongoing and planned trial information is needed by health workers, researchers, policy makers, consumers and other stakeholders, in order to apply the best available strategies to treat and prevent the disease and to plan future research.

Objectives: To identify and describe randomized controlled trials (RCTs) of TB conducted in Africa.

Methods: We searched electronic databases to identify RCTs of TB in January 2013 The search strategy incorporates the highly sensitive RCT search string developed by the Cochrane Collaboration and an African trials search filter developed and validated at the South African Cochrane Centre. We searched the Pan African Clinical Trials Registry (www.pactr.org) for data on on-going trials.We analyzed the distribution of trials by country and by decade and will further analyze trials conducted in the past 20 years for clinical characteristics, principal investigators location and funding patterns.

Results: We obtained 4479 records describing tuberculosis in Africa between 1966 and 2011. Of, 197 controlled trials 51 trials focused on prevention, 135 on treatment and 33 on vaccines. Fifty-four included children as participants. The highest numberof trials were conducted in South Africa (67) Uganda (20), Tanzania (17), Malawi (14), Nigeria (6) and Zimbabwe (5). Currently there are 27 TB related trials registered in www.pactr.org Current studies are conducted in South Africa (6), Tanzania (3), and one each in Gabon, Zimbabwe, Zambia, Uganda, Mozambique.

Conclusions: Trial research related to TB is extensive and widespread in South Africa. The focus on treatment, and the density of trials in the sub-Saharan region highlight the disease burden of the region. Exploring the TB trial landscape on the African continent can assist in directing limited funds to appropriate endeavours.