MRC clinical and community HIV/TB research collaborating centre symposium

19 Oct 2017 - 11:15

The MRC Clinical And Community HIV-TB Research Collaborating Centre was established in 2015 between UCT and Walter Sisulu University (WSU). The Centre aims to develop research capacity and skills in the fields of HIV and TB, and to build partnerships between UCT and institutions in the Eastern Cape. With the support of the Collaborative Centre, UCT has established a Research Unit at Jose Pearson Hospital which is managed by a research nurse, Sr Liziwe Rwentela, who is employed by UCT.  

The Centre is led by Professor Graeme Meintjes from CIDRI-Africa in the IDM and Department of Medicine at UCT. The leadership team comprises: Dr Limpho Ramagoaela from Jose Pearson Hospital and Drs John Black and Garrick Barber from Livingstone Hospital, all in Port Elizabeth; and Drs Andy Parrish and Dave Stead from Cecilia Makiwane Hospital and Walter Sisulu University in East London.

Two activities were held in Port Elizabeth over 19th and 20th October 2017 to support the research and educational aims of the Collaborative Centre:

A business meeting on Thursday 19th October to discuss current and future collaborative studies.

This was held at Jose Pearson Hospital in Port Elizabeth on 19th October 2017, and was attended by members of the leadership team. The agenda included an update on the Collaborative Centre funding for 2018, and discussions on the progress of existing studies at Jose Pearson Hospital and plans for future studies, mainly to be conducted in East London. The current projects at Jose Pearson include a prospective cohort study to evaluate drug exposures and clinical outcomes of patients with drug-resistant TB, with a focus on bedaquiline and linezolid, as well as a study to describe linezolid resistance amongst patients with treatment failure. Proposed projects for East London included a study of urine-based diagnostics for hospitalised patients with HIV, and an evaluation of the programmatic outcomes of patients on the new short course regimen for MDR-TB.

 

Sean & LiziweJose Pearson Research Unit

Left: Dr Sean Wasserman and Sr Liziwe Rwentela      Right: Collaborating Centre Committee Jose Pearson Research Unit

 

A Symposium on Friday 20th October 2017 at Livingstone Hospital in Port Elizabeth.

 

Organising committee & presenters

L to R: Organising Committee and presenters: Gary Maartens, Graeme Meintjes, Fareed Abdullah, Sean Wasserman, Kathryn Wood, John Black, Lindelwa Cindi, Candice Roux, Garrick Barber, Mpiko Ntsekhe, Limpho Ramangoaela, Andy Parrish and Dave Stead

 

The Symposium was held over one day in the auditorium of the Resource Centre based at Livingstone Hospital. The event brought together experts from around the country, as well as local speakers, to cover topics in TB and HIV and to provide networking opportunities for clinicians working in the Eastern Cape.  The symposium included the following sessions:

Challenges in HIV-TB management

Dr John Black from Livingstone Hospital discussed TB epidemiology in the Eastern Cape and the clinical challenges relating to the high burden of TB in the region. Dr Fareed Abdullah, the director of the SA-MRC Office of AIDS/TB Research presented an overview of the status of these diseases in South Africa, as well as the research priorities of the SAMRC in HIV-TB. He was accompanied by Ms Candice Roux, Project Manager for the SAMRC HIV-TB Collaborating Centres. Key issues in the clinical management of HIV-TB were covered by Profs Gary Maartens and Graeme Meintjes with talks on drug interactions between ART and TB treatment and TB-IRIS, respectively.

Drug resistant TB

The local experience with treating XDR-TB was presented by Dr Limpho Ramagoaela from Jose Pearson Hospital.  Dr Lindelwa Cindi described the challenges in interpretation of discordant results of drug susceptibility testing at Nkqubela Hospital in East London. The latest results from NIX-TB, STREAM-1, and the delamanid phase 3 trial were presented by Dr Francesca Conradie from the Wits Health Consortium. Dr Garrick Barber from Livingstone Hospital discussed the role of rifabutin in DR-TB and his planned research on this issue, and Prof Maartens gave a presentation on the mechanisms and management of drug-related QT prolongation.

Research Journey

In line with the Collaborating Centre’s aim to develop research capacity in the Eastern Cape, a full session was dedicated to practical advice on various aspects of clinical research. Talks included how to define a research question by Professor Graeme Meintjes, writing a research proposal by Professor Gary Maartens, applying for research funding by Dr Sean Wasserman and the ethical issues of conducting research in a busy clinical setting Professor Andy Parrish.

Key issues in TB diagnosis and management

This final session included a presentation on the role of urine LAM and other urine-based diagnostics to improve outcomes in HIV-TB, presented by Dr Dave Stead from Cecilia Makiwane Hospital. Dr Sean Wasserman from CIDRI-Africa discussed the use of linezolid in DR-TB. Prof Mpiko Ntsehke gave a talk on the research journey of the IMPI trial and showed how the findings influenced the management of TB pericarditis.

 

The Symposium was very well received and supported with 140 delegates filling the auditorium beyond capacity!

Following comments from the delegates on the day and a feedback questionnaire, a need for continued sessions in this field of research would be greatly appreciated.

  • 95% of respondents felt that the topics were relevant and useful for their clinical or research work.
  • 94% felt that the information would positively affect their clinical practice.

Some comments received:

  • Well planned and organized, Topics were well presented
  • The session was extremely informative, but a bit too crammed with too many speakers
  • Thank you for a well presented topic and all the issues that we would never have thought about.
  • Share the slides of all presentations to reflect on the information later
  • A bit doctor orientated, Sessions must be more nurse orientated as well

 

Presentations

Welcome to HIV-TB Research Symposium
Graeme Meintjes                   University of Cape Town

Defining a research question
Graeme Meintjes                   University of Cape Town

TB-IRIS (Tuberculosis Immune Reconstitution Inflammatory Syndrome)
Graeme Meintjes                   University of Cape Town

Drug Interactions with ART and TB Treatment 
Gary Maartens                        University of Cape Town

Writing a research proposal 
Gary Maartens                       University of Cape Town

The QT Interval – Safety endpoint for DR-TB trials
Gary Maartens                       University of Cape Town

Clinical Experience of treating XDR-TB at Jose Pearson
Limpho Ramangoaela            Jose Pearson TB Hospital

Discordant results of drug-susceptibility testing
Lindelwa Cindi                        Nkqubela Hospital

TB epidemiology and clinical challenges in the Eastern Cape
John Black                               Livingstone Hospital

Ethical issues regarding undertaking clinical research in a busy clinical setting
Andy Parrish                           Cecilia Makiwane Hospital (WSU)

Urinary TB Diagnostics in HIV
Dave Stead                             Cecilia Makiwane Hospital (WSU)

Applying for research funding
Sean Wasserman                   University of Cape Town

Linezolid in Drug Resistant TB
Sean Wasserman                   University of Cape Town

Management of TB pericarditis: lessons from IMPI
Mpiko Ntsekhe                       University of Cape Town

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