CHASE-TB is a 5-year cluster-randomized trial funded by the United States National Institutes of Health (NIH) that aims to evaluate the comparative effectiveness and implementation of two approaches to TB screening: a clinic- based approach that conducts screening on the grounds of a district hospital or health centre, and a ‘’hotspot’’-focused approach that takes the screening to community settings thought to have a high burden of undiagnosed TB. In both arms, participants are screened by chest X-ray, that X-ray is read using artificial intelligence, people with high-risk X-rays receive sputum Xpert testing, and people who screen negative for TB are offered further testing for latent TB infection and TB Preventive Therapy (TPT). The
study is being conducted at 12 health facilities & their surrounding communities: 8 facilities are implementing TB screening, alternating between the clinic-based and the hotspot-based approaches, and four (4) are continuing with current practice as comparators. The study’s primary aims are to:
1) Compare the effectiveness of hotspot-focused versus facility-based active case-finding (ACF) + linkage to TPT, in terms of the number of individuals started on treatment for microbiologically confirmed TB in each community
2) Measure the implementation of hotspot-based and facility-based ACF + TPT, including the reach, implementation, maintenance, and costs.
3) Estimate (using simulation) the impact of each intervention on diagnostic delays and TB prevalence.
This study will directly inform the implementation of TB case finding and prevention at a critical moment when new innovations (mobile X-ray, AI-based reading, short-course TPT) are making these interventions broadly scalable in high-TB-burden settings. Our pragmatic design will provide TB programs with essential guidance on how to implement ACF/TPT in diverse real-world settings.
The study started enrollment in June 2022 and will be continuing through 2027. For more information, see our publications page.
CHASE TB Team Members
Principal Investigators: Emily Kendall, David Dowdy
Local Principal Investigator: Achilles Katamba
Coordinator: Peter James Kitonsa
Data Analyst: Annet Nalutaaya
Lab Technologist: Caleb Kamoga
Screening Team Leads: Susan Birabwa, David Isooba, Ivan Mugabi, Kenneth Ndyabayunga
Research Assistants: Hilda Atugonza, Irene Naluyima, Rogers Okura, Juliet Kakeeto, Jonathan Magezi, Deborah Nantale, Wilson Kamya.
Research Nurses: Ivan Mugabi, Immaculate Nakirijja, Racheal Talemwa
M&E: Irene Naluyima