"We cannot win the battle against AIDS if we do not also fight TB. TB is too often a death sentence for people with AIDS."
Nelson Mandela, July 2004
24 March 2015 SATVI marks World TB Day
On Saturday 28 March 2015 the South African Tuberculosis Vaccine Initiative (SATVI) marked World TB Day with a Wellness Expo at the Zwelethemba Sport Stadium in Worcester. The program for the day included a 3 Km Fun Run, a Kick TB Soccer Tournament, Indigenous games and health screening. Professor Marian Jacobs, retired Dean of UCT Health Sciences Faculty delivered the keynote address, to the 2 000-strong audience, which was followed by a mass awareness activity during which the audience donned masks to symbolise the importance of infection control to curb TB.
“Kick TB” Soccer Tournament
The Kick TB Soccer Tournament, which was launched on Saturday 7 March 2015 by the South African Football Association (SAFA) Cape Winelands and SATVI, saw 43 soccer teams (under 13, 15 & 17 leagues) compete against each other with six (6) teams emerging to play against each for the prized trophy on the Saturday 28 March 2015. The winning teams were Zwelethemba All StarsÂÂÂ in the under 13ÂÂÂ & 15 league and Boland Ajax in the under 17 league.
Kick TB Schools Program- Tuesday 24 March 2015
On World TB Day (24 March 2015), SATVI partnered with AERAS, a Global not for profit TB vaccine research group, to raise awareness about TB amongst primary and secondary school children in the Worcester area. The program, which was rolled out in four schools in Worcester area, teaches children about the signs and symptoms in a fun and interactive way, and reached about 5 000 children with its message.
15 April 2015 Vacancy: Postdoctoral Fellowship in Human TB Immunology South African Tuberculosis Vaccine Initiative
We are inviting applications for a postdoctoral fellowship within our dynamic group to conduct research on immunology of TB vaccines and biomarkers. The fellow will be based primarily in Cape Town, but will be expected to visit to our Clinical Field Site in Worcester, 110km from Cape Town. The project will entail characterization of non-conventional immunological effects of TB vaccination, development and standardization of immunological assays, as well as immunological oversight of clinical trials of new TB vaccines. The scope of the research provides opportunities to work in collaboration with global leaders in vaccinology, systems biology and specialists in innate and T cell immunology. The fellowship awarded to the successful incumbent will be valued between R260,000 and R320,000 and will depend on relevant experience and skills. The fellowship is compliant with the rules set by the SARS and is exempt from taxation and includes no benefits. No direct service will be required in return for the fellowship. To download the advertisement Click here.
21 January 2015 Vacancy: Associate Professor Clinical Immunology
The South African Tuberculosis Vaccine Initiative calls for applications for the vacancy as Clinical Immunologist at Associate Professor level.
The University of Cape Town's Faculty of Health Sciences, where history is forever being made, is still at it. The largest dedicated tuberculosis vaccine research group on the continent is making and has made significant advances in finding new and safe vaccines for all strains of TB, while also addressing other critical clinical, epidemiological, immunological and human genetic questions posed in the development of TB vaccines. As evidence, just refer to the manuscripts published by the South African Tuberculosis Vaccine Initiative in top-end journals. This unit enjoys considerable funding support from multiple international funding agencies.
To view the advert visit the University of Cape Town Website at: http://www.uct.ac.za/usr/about/intro/vacancies/execacad/2014/FHS_15011_AcademicPartners_Immunology.pdfÂÂÂ
October 2014 TB trial carried out in South Africa finds new once-weekly treatment
Research carried out by the Aurum Institute in Johannesburg, and the South African Tuberculosis Vaccine Initiative, Institute of Infectious Disease and Molecular Medicine (University of Cape Town), has found an alternative way to treat tuberculosis with fewer tablets than today’s recommended course of treatment. The novel drug combination makes it easier for patients to complete their course of treatment.
TB is a major health problem in South Africa. In 2012 there were 530,000 new cases of the disease, and 31,000 people died from it (excluding HIV deaths). Most cases of TB are curable if treated effectively and promptly. The standard treatment is four drugs daily for two months followed by two drugs daily for four months –around 360 tablets over a six-month period. The RIFAQUIN trial results show that a combination of the drugs Rifapentine and Moxifloxacin could reduce the number of tablets in a course of treatment to around 140 over the same six month period. Trial participants took Ethambutol, Moxifloxacin, Rifampicin, and Pyrazinamide daily during the first two months of treatment and then Rifapentine and Moxifloxacin once a week during the last four months.
The trial was carried out in Botswana, South Africa, Zambia and Zimbabwe, and led by St George’s, University of London together with the Medical Research Council Clinical Trials Unit at UCL. A total of 827 people took part in the trial, 464 of whom were from South Africa.
The results showed 96 percent of patients taking the six-month Rifapentine and Moxifloxacin combination were cured, which was as good as the standard treatment. Study participants were assessed 12 months after they had finished their treatment.
Associate Professor Mark Hatherill, lead investigator for the trial in Cape Town, said:
“The burden of taking tablets is huge for TB patients. Consequently, even with the best will in the world, patients sometimes stop their treatment once they begin to feel better. Over a long period of time this has led to more drug resistant strains.”
Dr Salome Charalambous, lead investigator for the trial in Johannesburg, said: “Less tablets means there is a higher chance of the patient completing their treatment. It also makes it easier for clinics to supervise treatment. This is particularly important for countries like South Africa, where clinics are very busy, and where it is not uncommon for patients to travel many miles to receive each treatment.”
The drug combination could also be used in patients with drug resistant strains because it doesn’t contain isoniazid, the drug that patients are most likely to be resistant to. The trial was also designed to test whether the length of treatment could be reduced from six months to four months. The results showed that the combination of Rifapentine and Moxifloxacin after the first two months of treatment does not allow shortening of treatment from six to four months. Patients still need to take their treatment for six months, but the new once-weekly drug combination could make that easier.
SATVI Investigator, Doctor Hennie Geldenhuys, said that “A large and complex trial like this is challenging but it shows that important research such as this can be performed to high standards in the developing world. The results make it worth the hard work."
Research Nurse, Danelle Van As, said that “This study was very exciting because of the possibility that TB patients may take less tablets daily and that the time of treating TB could be shortened.
RIFAQUIN is a unique TB trial, as it investigated both shortening and simplifying treatment, and used higher doses of Rifapentine than other studies that have looked at shortening TB treatment using Fluroquinolones.
The findings, which were funded by the European and Developing Countries Clinical Trials Partnership, are published in the New England Journal of Medicine Today of 23 October 2014.
The researchers point out that a number of considerations need further investigation before health services could prescribe the once-weekly treatment combination. These include the cost effectiveness of the new regimen, and more data on the effectiveness of the proposed regimen in HIV-positive patients, who are particularly at risk of TB.
June 2014- Safety and reactogenicity of BCG revaccination with isoniazid pretreatment in TST positive adults.
Title of Paper Published:Safety and reactogenicity of BCG revaccination with isoniazid pretreatment in TST positive adults.
Authors:Hatherill M, Geldenhuys H, Pienaar B, Suliman S, Chheng P, Debanne SM, Hoft DF, Boom WH, Hanekom WA, Johnson JL.
Journal published in: Vaccine. 2014 Jun 30;32(31):3982-8. doi: 10.1016/j.vaccine.2014.04.084. Epub 2014 May 9.
Impact factor: 3.492
Global tuberculosis (TB) control may require mass vaccination with a new TB vaccine, such as a recombinant bacille Calmette Guerin (BCG) or attenuated Mycobacterium tuberculosis (MTB). The safety profile of live mycobacterial vaccines in latently infected adults with prior infant BCG vaccination is unknown.
Evaluate safety and reactogenicity of BCG revaccination, with or without isoniazid (INH) pretreatment, in adults with latent MTB infection (LTBI).
Eighty-two healthy, HIV uninfected, South African adults, with a BCG scar and tuberculin skin test (TST) diameter ≥ 15 mm, were randomized to receive 6 months of INH, starting either before, or 6 months after, intradermal revaccination with BCG Vaccine SSI (Statens Serum Institut, Copenhagen). Safety and reactogenicity data are reported through 3 months post BCG revaccination.
Baseline characteristics were similar between treatment arms. Mean baseline TST diameter was 20 ± 4 mm. Seventy-two subjects received BCG revaccination. Injection site erythema (68%) and induration (86%) peaked 1 week after revaccination. Ulceration (76%) peaked at 2 weeks, and resolved by 3 months in all but 3 subjects. Diameter of ulceration was >10mm in only 8%, but a residual scar was common (85%). No regional lymphadenitis or serious morbidity related to BCG was seen. Reactogenicity was not affected by INH pretreatment.
BCG revaccination of MTB infected adults is safe, well tolerated, and reactogenicity is similar to that of primary BCG vaccination. Clinical trials of live recombinant BCG or attenuated MTB vaccines may be considered in latently infected adults, with or without INH pretreatment (ClinicalTrials.gov identifier: NCT01119521).
Copyright © 2014 Elsevier Ltd. All rights reserved.
BCG; Isoniazid; LTBI; Revaccination; SafetyÂ
July 2014 A controlled trial of sputum induction and routine collection methods for TB diagnosis in a South African community.
Authors:Geldenhuys HD, Whitelaw A, Tameris MD, Van As D, Luabeya KK, Mahomed H, Hussey G, Hanekom WA, Hatherill M.
Journal Published in:Eur J Clin Microbiol Infect Dis. 2014 Jul 15. [Epub ahead of print]
Impact factor: 3.024
The diagnostic yield of pulmonary tuberculosis (TB) by sputum induction (SI) at the first point of contact with health services, conducted in all patients with suspected TB regardless of the ability to expectorate spontaneously, has not been evaluated. We compared the diagnostic yield of SI to routine sputum collection in a South African community setting. Ambulatory patients with suspected TB provided a 'spot' expectorated sputum sample, an SI sample by hypertonic (5Â %) saline nebulization, and early morning expectorated sputum sample. The diagnostic yield of sputum smear microscopy and liquid culture (denominator all subjects with any positive Mycobacterium tuberculosis culture), and time-to-positivity of culture were compared between SI and expectorated samples. A total of 555 subjects completed the SI procedure, of whom 132 (24Â %) were human immunodeficiency virus (HIV)-infected. One hundred and twenty-nine samples (129, 23Â %) were M. tuberculosis culture-positive. The time-to-positivity of Mycobacteria Growth Indicator Tube (MGIT) culture was shorter for SI (median difference 2ÂÂÂÂ days, p = 0.63) and for early morning expectorated sputum (median difference 2Â days, p = 0.02) compared to spot expectorated sputum. However, there was no difference in the culture-positive diagnostic yield between SI and spot expectorated sputum [difference +0.7Â %; confidence interval (CI) -7.0 to +8.5Â %, p = 0.82] or SI and early morning expectorated sputum (difference +4.7Â %; CI -3.2 to +12.5Â %, p = 0.20) for all subjects or for HIV-infected subjects. SI reduces the time to positive M. tuberculosis culture, but does not increase the rate of positive culture compared to routine expectorated sputum collection. SI cannot be recommended as the routine collection method at first contact among ambulatory patients with suspected TB in high-burden communities.
SATVI gets approval from USA based clinical research organisation
SATVI gets site approval from USA based clinical research organisation
Scientists at the UCT based South African Tuberculosis Vaccine Initiative (SATVI) were ecstatic with the announcement by the Division of AIDS (DAIDS) of the National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), USA that SATVI meets it’s stringent requirements for participation in international clinical trials. On Tuesday 19 August 2014, the DAIDS Branch Chief, Ms Donna Germuda announced that “SATVI has met all the stringent requirements of the DAIDS site approval process”.
4 August 2014 Joint collaboration between UCT biomedical research units to expose children to the world of biomedical TB research.
According to Anastasia Koch, PhD student attached to the Molecular Mycobacteriology Research Unit of the University of Cape Town, “the project started in an organic, informal way as part of the UCT Post-Graduate Student Council,
14 August 2014- SATVI Accredited as UCT Research Site
“SATVI has a world-beating track record of successful TB vaccine trials, coupled with highly innovative TB immunology studies, which together are responsible for the group’s increased publication output in high impact journals”
Professor Willem Hanekom, who has been with the South African Tuberculosis Vaccine Initiative (SATVI) for the past eight years, recently said his farewells to staff, friends and colleagues at the University of Cape Town, before taking up a key position at the Bill and Melinda Gates Foundation, where he will be focusing on the development of a global policy for TB vaccine development.
Willem who has been appointed Deputy Director, Program lead for TB Vaccines, at the Seattle based Bill Gates Foundation, was the Director of SATVI since 2011 and has vast expertise in clinical trials involving protective host responses to TB and has contributed to more than 120 publications. Willem is past president of the Federation of African Immunological Societies, and has served on multiple international advisory committees in TB vaccine development and translational immunology.
According to Professor Mark Hatherill, Director of SATVI, who spoke at his farewell function, “Willem is respected by international scientists and the new position he assumes at the Gates Foundation provides an opportunity for him to direct and give input into TB vaccine research at a global level. Within the scientific community everyone is aware of Willem’s association with SATVI, the work that SATVI does and therefore he would play an important role as brand ambassador for SATVI within the global TB vaccine research community”.
Dr Zameer Brey, SATVI Chief Operating Officer, thanked and applauded Professor Hanekom for his contribution on many levels. “Willem is an excellent teacher, mentor and role model. He has an inspirational leadership style and has a way of bringing out the best in people working with him. At an organisational level, Willem was instrumental in building a legacy for SATVI underpinned by a clear strategy, a focus on systems for long term sustainability and the recognition that people are core to any organisational success. Finally, his contribution to the TB vaccine world and the fight against TB is evidenced by his phenomenal publication record, successful grant proposals and by the multiple advisory groups he provides council to globally.”
Mrs Ashley Veldsman, Regulatory Specialist at SATVI, told us that whilst it was sad to see him go, “that Â it was in effect an accolade and recognition of the calibre of people and research which SATVI and UCT delivers and that his departure would serve as an important North-South collaboration, not just to showcase what SATVI is capable of, but also what the African continent can offer the world”.
In his address Professor Hanekom, told SATVI staff he finally decided to join the Foundation when, as researcher, faced with the challenge of a watershed in tuberculosis research at global level, he realised that there is a need for a rethink on how we work together internationally, the need for developing new scientific approaches, new ways of conducting clinical trials; and that he saw the opportunity to join the Gates Foundation to work on a global strategy towards eradicating TB through the development of a vaccine. According to him it would take two to three years to develop and start and implement such a strategy.
He commended SATVI staff that there was no other group as good as SATVI in getting research done, completing the research and producing results.