South Africa’s groundbreaking study revolutionizes global TB treatment policy

BEAT-Tuberculosis is the world’s first programme dedicated to addressing drug-resistant tuberculosis in all populations, impacting the World Health Organisation’s global TB treatment policy.

According to the principal investigator for this study, Dr Francesca Conradie, it has been demonstrated that the new short oral regimen is safe and effective for these key populations, which signals a pivotal step toward TB healthcare that is more comprehensive and equitable.

“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.

In this study, a novel shortened treatment regimen for DR-TB was compared with the established standard of care to determine its effectiveness and safety.

Traditionally, a combination of seven medications was administered over a period of nine months, while a regimen of four to five medications had to be administered over only six months, including newer agents like bedaquiline and delamanid.

It took six years for the BEAT-Tuberculosis clinical study to be conducted at the Clinical HIV Research Unit (CHRU) in the Eastern Cape and KwaZulu-Natal.

In 2019 just before the unprecedented Covid-19 pandemic, over 400 people were enrolled across both provinces and the study became a success despite the daunting challenges posed by the pandemic.

Additionally, the study sought to build DR-TB research capacity in the Eastern Cape and KwaZulu-Natal through community engagement and training of healthcare personnel.

“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.

Several stakeholders collaborated to make this study possible, including the National Department of Health, United States Agency for International Development and the University of Witwatersrand.

As a result of the study, WHO policy has been influenced and the Global South has been put at the forefront of improving TB treatment.

The National Department of Health’s Chief Director of TB Control and Management, Professor Norbert Ndjeka, estimated that in 2022, 280 000 people would be diagnosed with TB in South Africa and 54 000 would die from it.

As the second leading cause of death in South Africa and a threat to global public health, tuberculosis remains a major health concern.

“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,” said USAID Southern Africa Mission Director, Leslie Marbury

According to Marbury, the National Department of Health and her organization have improved TB patient care worldwide, and the organization celebrates 400 participants who made the trial possible.

Additionally, she thanked all stakeholders involved in BEAT Tuberculosis, including the National Department of Health, the Eastern Cape and KwaZulu-Natal Health Departments, as well as local medical facilities that contributed to this globally recognized study.

According to the World Health Organisation TB symptoms are as follows:

• Prolonged cough (sometimes with blood), chest pain, weakness, fatigue, weight loss, fever and night sweats.
• Although TB affects the lungs most often, it can also affect the kidneys, brain, spine, and skin.
• Anyone with these symptoms is urged to go to their local clinic.
• A sputum or phlegm sample will be collected for TB testing. If TB is detected, the correct treatment will be administered.