The Johns Hopkins-based Consortium to Respond
Effectively to the AIDS/TB Epidemic, known as CREATE, has
announced the start of three studies to evaluate novel
techniques for controlling HIV-related TB in countries hard
hit by the dual epidemics.
"Innovative public health measures to contain
AIDS-related TB are urgently needed in the developing
world," said principal investigator Richard E. Chaisson,
professor in the School of Medicine. "CREATE's
community-level studies will assess bold new approaches for
driving down the skyrocketing rates of TB in areas with
severe HIV epidemics."
The World Health Organization's Global Tuberculosis
Control 2005 report notes that global TB prevalence has
declined by more than 20 percent since 1990 and that
incidence rates are now falling or stable in five of the
six WHO regions of the world. The exception is Africa,
where TB incidence rates have tripled since 1990 in
countries with high HIV prevalence and continue to rise
across the continent at 3 percent to 4 percent annually.
CREATE, funded by the Bill and Melinda Gates
Foundation, was launched by Nelson Mandela at the July 2004
International AIDS Conference.
In addition to Johns Hopkins, CREATE participants are
Aurum Health Research, South Africa; London School of
Hygiene and Tropical Medicine; Municipal Health Secretariat
Communicable Disease Program Rio de Janeiro, Brazil; and
the WHO Stop TB Department, Geneva.
With the goal of reducing death and disease from TB in
AIDS-endemic populations, the partners have designed three
projects in South Africa, Zambia and Brazil, which have all
moved into implementation.
ZAMSTAR, the Zambia and South Africa Tuberculosis and
AIDS Reduction Study, plans to empower communities to seek
care for their tuberculosis, providing direct access to
diagnostic services and increasing community awareness. The
project will provide TB tests and free HIV counseling and
testing within the households of TB patients.
In Brazil, the THRio project, a collaboration with the
Health Department in Rio de Janeiro, will introduce
preventive TB therapy to patients receiving HIV treatment
in 29 public clinics in that city.
The Thibela TB project will be carried out in gold
mines located in three South African provinces and will
determine whether TB preventive therapy given to an entire
high-risk community is more effective than TB preventive
therapy given only to high-risk individuals. More than
50,000 miners will be included in the study.
The CREATE studies will produce information about
strategies for improving TB control in areas affected by
HIV over the next five to six years. Working with WHO
ensures that the results will reach global and national
policy-makers so that the best methods of reducing death
and disease are followed in all countries.
GO TO