Expanding and Improving TB Prevention
Tuberculosis (TB) is the world’s deadliest infectious disease, responsible for approximately 1.3 million deaths globally. People living with HIV are particularly vulnerable to TB because of their weakened immune systems. In 2023, TB accounted for 161,000 HIV-associated deaths, making it the leading cause of death among people living with HIV.
To help address this dual health threat, the CDC Foundation launched the Preventing Occurrence of Tuberculosis by Expanding Coverage of Tuberculosis Preventive Treatment among People Living with HIV (PROTECT) project in 2021. TB preventive treatment (TPT) is a 3–6-month course of anti-TB medicines used to prevent latent TB infection from progressing to active TB clinical disease. Clinical trials have shown that TPT substantially reduces the number of TB cases and deaths, but there is limited data from real-world clinical settings. The PROTECT project uses electronic medical record data from individual patients to evaluate how effective TPT is at preventing TB disease and TB-related deaths among people living with HIV.
With support from the Bill & Melinda Gates Foundation, the PROTECT project examines data from six countries—Nigeria, Haiti, Uganda, Zimbabwe, Ukraine and Kenya—to assess the impact of TPT and use these findings to improve TB prevention efforts. Three years into this exciting project, we have strengthened TB/HIV data systems in these countries, improved the research capacity of local teams and developed helpful TB prevention resources.
Sharing knowledge is a key step toward tackling public health challenges like TB. Through the PROTECT project, we collaborated with the International Union Against Tuberculosis and Lung Disease (The Union) to launch a training course on developing a proposal for operational research, an approach that uses quantitative and qualitative methods to analyze public health issues and inform policies. Starting in November 2023, participants from our implementing countries engaged in a rigorous, six-month curriculum that provided them with practical tools and resources, including a mentor, to help develop and define their research questions, methodologies and proposals. By the end of the course, participants had developed a complete research proposal and were empowered to submit their proposals to potential funders. The course has also been made available online on the Union’s website for researchers interested in enhancing their skills.
In June 2024, we organized the PROTECT project’s second annual workshop in Victoria Falls, Zimbabwe, bringing together over 30 team members from the six project countries to share preliminary results and strategize on disseminating results. Partners shared project successes, including strengthened integration of countries’ TB/HIV electronic reporting systems, enhanced collaboration across countries and new best practices for TPT implementation.
TPT is a critical public health measure that protects individuals and communities from TB. By contributing vital information about TPT to global TB prevention efforts, the innovative PROTECT program will improve health outcomes and help save countless lives.
The PROTECT project is funded by the Bill & Melinda Gates Foundation and is a collaboration between the U.S. Centers for Disease Control and Prevention (CDC), Emory University, Eastern Deanery AIDS Relief Program (EDARP), Catholic Medical Mission Board (CMMB), Georgetown Global Health Nigeria (GGHN), Makerere University School of Public Health – Monitoring And Evaluation Technical Support (MakSPH-METS), Public Health Center, Ministry of Health, Ukraine and Zimbabwe Technical Assistance, Training and Education Center for Health (Zim-TTECH).
