A Trial of the Urine LAM Strip Test for TB Diagnosis Amongst Hospitalized HIV-infected Patients (LAMRCT)
This study is currently recruiting participants.
Verified January 2013 by University of Cape Town
Sponsor:
University of Cape Town
Collaborators:
University of Zimbabwe
University of Zambia
NIMR - Mbeya Medical Research Programme
Information provided by (Responsible Party):
Jonathan Peter, University of Cape Town
ClinicalTrials.gov Identifier:
NCT01770730
First received: January 11, 2013
Last updated: January 15, 2013
Last verified: January 2013
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Purpose
The novel urine LAM point-of-care strip test offers potential clinical utility to improve TB diagnosis in HIV co-infected patients. Urine LAM strip test performance improves with increasing illness severity and more advanced immunosuppression, thus offering the greatest potential utility in hospitalised HIV-infected patients with advanced immunosuppression (CD4 cell count less than 200). However, in the context of high rates of empiric treatment and the availability of other novel TB diagnostics, the clinical impact of the urine LAM strip test is unknown. This study will investigate the impact of the urine LAM strip test. The study hypothesis is that the urine LAM strip test, when combined with standard TB diagnostics (smear microscopy and culture) will significantly improve TB treatment-related outcomes (TB-related mortality, morbidity and length of hospital stay) in HIV-infected hospitalized patients when compared to standard TB diagnostics alone.
| Condition | Intervention |
|---|---|
|
Tuberculosis |
Device: Urine LAM strip test |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Diagnostic |
| Official Title: | A Randomized Controlled Trial to Evaluate the Impact of Using a Point-of-care Urine LAM Strip Test for TB Diagnosis Amongst Hospitalized HIV-infected Patients in Resource-poor Settings |
Resource links provided by NLM:
Further study details as provided by University of Cape Town:
Primary Outcome Measures:
- All-cause mortality [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]All-cause mortality at 8-weeks after study enrollment
Secondary Outcome Measures:
- Change in TB-related morbidity score [ Time Frame: Baseline and 8 weeks ] [ Designated as safety issue: No ]Comparative change in TB score between baseline and 8 weeks after enrollment
- Change in Karnofsky performance index [ Time Frame: Baseline and 8 week ] [ Designated as safety issue: No ]Comparative changes in the Karnofsky performance index between baseline and 8 weeks following enrollment
- Hospital length of stay [ Time Frame: Date of hospital discharge (max 8 weeks) minus date of admission ] [ Designated as safety issue: No ]This is the number of days of hospital admission for enrolled patients up to a maximum of 8 weeks post enrollment.
- Diagnostic accuracy of urine LAM strip test [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]Diagnostic accuracy (sensitivity, specificity, predictive values and likelihood ratios) of the urine LAM strip test using TB culture as the diagnostic reference standard
| Estimated Enrollment: | 2400 |
| Study Start Date: | January 2013 |
| Estimated Study Completion Date: | April 2014 |
| Estimated Primary Completion Date: | April 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: LAM plus standard care
Patients allocated to this study arm will receive urine LAM strip testing in addition to the standard TB diagnostic tools WHO approved and available at each site
|
Device: Urine LAM strip test
This is a point-of-care lateral flow strip test to detect the presence of lipoarabinomannan (LAM) in patient urine samples. Only patients with a grade 2-5 visual band intensity will be considered positive and commenced on treatment
Other Name: Determine TB urine LAM Antigen strip test
|
|
No Intervention: Standard care
Patients allocated to this study arm will receive standard TB diagnostics currently WHO approved and available at the study site
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Criteria
Inclusion Criteria:
- HIV-infected (1x rapid HIV test positive)
- Considered TB suspect by attending doctor (must comprise at least 1 of the following: current fever or cough, drenching night sweats, self-reported LOW)
- Illness severity sufficient to warrant hospitalization
- ≥18 years old
- Provision of informed consent
Exclusion Criteria:
- HIV-uninfected
- Patients receiving any anti-TB medication in the 60 days prior to testing
- Unable to provide 30mls urine
- Inability to provide informed consent
Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01770730
Contacts
| Contact: Jonathan Peter, MD | +27214066119 | Jonny.Peter@uct.ac.za |
| Contact: Keertan Dheda, MD PhD | +27214067654 | Keertan.Dheda@uct.ac.za |
Locations
| South Africa | |
| University of Cape Town | Recruiting |
| Cape Town, Western Cape, South Africa, 7945 | |
| Contact: Jonathan Peter, MD +27214066119 Jonny.Peter@uct.ac.za | |
| Principal Investigator: Jonathan Peter, MD | |
| Sub-Investigator: Keertan Dheda, MD | |
| Sub-Investigator: Grant Theron, PhD | |
| Tanzania | |
| Mbeya Medical Research Programme | Recruiting |
| Mbeya, Tanzania | |
| Contact: Petra Clowes, MD +255252503364 pclowes@mmrp.org | |
| Principal Investigator: Michael Hoelscher, MD | |
| Sub-Investigator: Andrea Rachow, MD | |
| Sub-Investigator: Petra Clowes, MD | |
| Zambia | |
| University Teaching Hospital | Not yet recruiting |
| Lusaka, Zambia | |
| Contact: Duncan Chanda, MD +260964100097 duncanchanda@gmail.com | |
| Principal Investigator: Duncan Chanda, MD | |
| Sub-Investigator: Peter Mwaba, MD | |
| Zimbabwe | |
| University of Zimbabwe | Not yet recruiting |
| Harare, Zimbabwe | |
| Contact: Lynn Zijenah, PhD +2634791631 lzijenah@gmail.com | |
| Principal Investigator: Lynn Zijenah, PhD | |
Sponsors and Collaborators
University of Cape Town
University of Zimbabwe
University of Zambia
NIMR - Mbeya Medical Research Programme
Investigators
| Study Director: | Keertan Dheda, MD | UCT Lung Infection and Immunity Unit |
More Information
Additional Information:
Publications:
| Responsible Party: | Jonathan Peter, Honorary consultant, Department of Medicine, University of Cape Town |
| ClinicalTrials.gov Identifier: | NCT01770730 History of Changes |
| Other Study ID Numbers: | LAMRCT |
| Study First Received: | January 11, 2013 |
| Last Updated: | January 15, 2013 |
| Health Authority: | South Africa: Human Research Ethics Committee |
Keywords provided by University of Cape Town:
|
urine LAM strip test diagnostics tuberculosis |
Additional relevant MeSH terms:
|
Tuberculosis Mycobacterium Infections Actinomycetales Infections Gram-Positive Bacterial Infections Bacterial Infections |
ClinicalTrials.gov processed this record on May 16, 2013