PEDI-OUTCOMES: PEDIatric Observational study to Understand post-TB Treatment Completion Morbidity including Environmental and Spatial links

Abstract

Our aim in this study is to elucidate the effect of personal air pollutant exposure on children’s development of tuberculosis (TB) and post TB lung disease (PTLD) in rural South Africa, a high TB prevalence setting, by prospectively collecting and analyzing data on TB clinical history, air pollutant exposure, lung functioning, and quality of life. Each year, more than 1.1 million children globally develop TB and one quarter of them die, despite TB being treatable for more than 70 years. However, if TB is diagnosed and treated appropriately, mortality can be <1%. Therefore, the burden of TB morbidity and post TB lung disease is poorly quantified in children, but is likely high given that between 60 and 90% of adults who survive TB experience PTLD. There is an urgent need for strategies to better identify, screen, diagnose, treat, and care for children during and after TB treatment. Additionally, poor air quality is another major issue among children in sub-Saharan Africa, also damaging children’s lungs and further increasing risk of developing TB. Therefore, again, we aim to understand the effect of air pollution exposure on childhood development of TB and PTLD in children.

Additional Grants

• Submitted CFAR Award (funded) ($40,000 over 1 year)
• Submitted SPARK Award (funded) ($200,000 over 2 years)

Students Trained 

• 1 Undergraduate Students
  • Jenny Hotchkiss
    
• 1 Graduate Students
  • Numi Oyebode
    
• 1 Research Associate 

Additional Accomplishments 

• IRB approved at Boston College and Nelson Mandela University
• Developed partnerships between Boston College study team and AQUITY Innovations (NGO) and 8 clinics in Nelson Mandela Bay Metro for recruitment
• REDCap database developed including 14 tools being used at three timepoints
• Trained and hired nurse project manager; attended oscillometry training, spirometry training, passive air sampler training.
• PI conducted site visit in June 2024 with Yale MPH student
• Successfully procured oscillometer, spirometer, wristbands, mouth filters from four different vendors from Australia, USA, and South Africa