Meet Manthomeng Matete, who coordinates the Community and Universal Testing for TB among Contacts (CUT-TB) study in Lesotho. A three-country study, CUT-TB is evaluating new contact tracing strategies with the ultimate aim of improving case detection. Jhpiego leads the study in Lesotho in partnership with The Aurum Institute.
What problems is study hoping to solve?
Eliminating TB will require increasing access to prevention, treatment, care and support services. But until contact tracing is more robust, this will be an elusive goal. The disease remains a global threat because linking people to care means finding them first and our current approaches to screening contacts are not reaching everyone.
This is where CUT-TB comes in. The study, taking place in South Africa, Lesotho and Tanzania, introduces two new strategies to test for latent TB (the presence of TB in the body, but without symptoms of illness). The testing strategies, which involve universal blood-based testing of all household contacts, regardless of symptoms, have the potential to reach all people in a household to test for both TB disease and TB infection. TB preventive treatment (TPT) is provided to all people living with HIV as well as children exposed to clients diagnosed with TB disease.
What is Jhpiego’s role in this research?
Jhpiego supplies the staff and expertise that make this study happen. The principal investigators—Jhpiego’s Stacie Stender, Nyane Nonyana and Aleisha Rozario and Dr. Llang Maama-Maime, manager of Lesotho’s National TB and Leprosy Program—provide technical support to the team on the ground. They help the Lesotho team ensure that patient recruitment is done according to the protocol and adheres to standards. Together with our partners—The Aurum Institute, the National Institute for Medical Research, Karolinska Institute, University College London and Research Center Borstel – Leibniz Lung Center—Jhpiego also coordinates trainings for study personnel, and ensures the availability of all equipment and supplies needed to process the study samples.
As study coordinator, I work hand in hand with our local partners in the three implementing districts. My responsibilities are varied and vast—from obtaining institutional review board approvals to managing the quality of data collection to creating rapport with all stakeholders.
How does this study fit into Jhpiego’s larger TB strategy in Lesotho?
Since 2008, Jhpiego has supported Lesotho’s Ministry of Health to deliver primary health care services, including TB and HIV integration. In 2018, with funding from The Global Fund to Fight AIDS, TB and Malaria, Jhpiego supported the Ministry of Health to establish a national TB contact tracing program under the THEBE (Prevention of HIV and TB in Lesotho through Evidence-Based Interventions and Education) project, which aimed to identify new cases through prompt and robust contact tracing strategies.
CUT-TB builds on these goals by adding latent TB testing for every household member of a TB index patient to Lesotho’s TB arsenal. This will help identify people we hadn’t before—those with both latent TB and TB disease among household members—and get them started on either TPT or TB treatment.
Who will benefit from the results of this study?
To start, all household contacts enrolled in the study who are diagnosed with either latent TB or TB disease will be linked to appropriate care. But the results of CUT-TB will be so much bigger than that.
If the lessons learned from this study inform future policy around improving testing and diagnostics for latent TB and TB disease, they will improve the lives of millions—here in Lesotho, where we have one of the highest rates of TB in the world, and beyond. There is not a single country or age group on earth not touched by this disease. If future decision-making and policy development are based on universal testing of contacts, I believe we can dramatically curb, or even end, TB.
What do you like best about doing this work?
I fell in love with research when I was doing my final thesis at university. Later, as a research assistant and supervisor on numerous studies, I saw firsthand that it’s research that makes new discoveries, policies and innovations possible—and improves lives.
Working with people who are so dedicated to their work is exciting and pushes me to be a better study coordinator. No matter how complex the work is, all stakeholders on CUT-TB are always there to offer moral and technical support.
Katrin DeCamp serves as a speechwriter and editor for Jhpiego.