A team of researchers and partners led by Professor Ben Marais have been awarded $4.25 million in Medical Research Future Fund (MRFF) funding to pave a pathway towards the elimination of TB in the Pacific.
Tuberculosis (TB) and leprosy present increasingly urgent health threats to our region, and are a daily challenge for the Pacific Nation of Kiribati. Kiribati, a vibrant collection of islands and atolls home to more than 120,000 people is located half-way between Australia and Hawaii. Kiribati suffers from overpopulation and is also vulnerable to rising sea-levels caused by climate change. The capital island of South Tarawa houses more than half the country's population in 16 square kilometres, and TB presents a continuing health risk to the I-Kiribati people.
As part of Australia's commitment to support the wellbeing of our Pacific Island neighbours, $8.3 million was dedicated to promote control of drug resistant TB (DR-TB) and antimicrobial resistance (AMR) in the Pacific, with $4.25 million to fund a community-wide screen-and-treat study for TB, DR-TB, latent TB infection and Leprosy in South Tarawa, led by Professor Ben Marais and Professor Warwick Britton. The study, Pathway to the Elimination of Antibiotic Resistant and Latent tuberculosis (as well at Leprosy) in the Pacific (PEARL), will screen every person aged 3 & older in a population of more than 65,000 people in South Tarawa, the capital atoll of the Republic of Kiribati. Each person will be tested for TBor leprosy disease or infection by symptom screening, tuberculin skin testing, leprosy skin check, digital chest X-ray with computer aided detection (CAD) software and sputum PCR testing (Xpert Ultra MTB/RIF). People with TB or leprosy disease will be referred to the National Programmes for treatment and those with TB infection will be treated with preventative therapy to diminish the pool of future disease activation. Those without disease (either TB or leprosy) or TB infection will be offered leprosy prophylaxis.
The PEARL study utilises concepts of whole population screening and active case finding, which was shown by PEARL study researchers Professor Guy Marks and Professor Greg Fox to halve TB over 4 years in the Asia-Pacific context of Vietnam (the ACT3 trial).
The study is a public health intervention delivered in partnership with the Kiribati Ministry of Health and Medical Services. Further elements of the study incorporate capacity building and education in TB control for Kiribati and 6 other Pacific Island nations in collaboration with the Australian Respiratory Council (ARC). Cost-efficiency and strategy modelling for the improvement of TB elimination studies will be included by study colleagues working in Melbourne at Monash University under the leadership of Associate Professor James Trauer. The leprosy components of the study are led by New Zealand colleagues from the Pacific Leprosy Foundation and Professor Stephen Chambers from the University of Otago in collaboration with the Kiribati National Leprosy Program.
The TB research is funded under the Medical Research Future Fund’s Global Health Initiative, which focuses on AMR and DR-TB as threats to global and national health security.
To access the grant press release, see here.
To get in touch with the PEARL study team, please contact us here.