s40121-022-00667-z.pdf (4.04 MB)
Capacity building in Sub-Saharan Africa as part of the INTENSE-TBM project during the COVID-19 pandemic.
journal contributionposted on 2022-08-04, 10:06 authored by E Ariza-Vioque, F Ello, H Andriamamonjisoa, V Machault, J González-Martín, MC Calvo-Cortés, S Eholié, GA Tchabert, T Ouassa, M Raberahona, R Rakotoarivelo, H Razafindrakoto, L Rahajamanana, RJ Wilkinson, A Davis, M Maxebengula, F Abrahams, C Muzoora, N Nakigozi, D Nyehangane, D Nanjebe, H Mbega, R Kaitano, M Bonnet, P Debeaudrap, JM Miró, X Anglaret, N Rakotosamimanana, A Calmy, F Bonnet, J Ambrosioni, INTENSE-TBM Group
Tuberculous meningitis (TBM) is the most severe and disabling form of tuberculosis (TB), with at least 100,000 cases per year and a mortality rate of up to 50% in individuals co-infected with human immunodeficiency virus type 1 (HIV-1). To evaluate the efficacy and safety of an intensified anti-tubercular regimen and an anti-inflammatory treatment, the INTENSE-TBM project includes a phase III randomised clinical trial (TBM-RCT) in four countries in sub-Saharan Africa (SSA). Within this framework, we designed a comprehensive capacity-building work package ensuring all centres had, or would acquire, the ability to conduct the TBM-RCT and developing a network of skilled researchers, clinical centres and microbiology laboratories. Here, we describe these activities, identify strengths/challenges and share tools adaptable to other projects, particularly in low- and lower-middle income countries with heterogeneous settings and during the coronavirus disease 2019 (COVID-19) pandemic. Despite major challenges, TBM-RCT initiation was achieved in all sites, promoting enhanced local healthcare systems and encouraging further clinical research in SSA. In terms of certified trainings, the achievement levels were 95% (124/131) for good clinical practice, 91% (39/43) for good clinical laboratory practice and 91% (48/53) for infection prevention and control. Platform-based research, developed as part of capacity-building activities for specific projects, may be a valuable tool in fighting future infectious diseases and in developing high-level research in Africa.