Understanding the biology, morbidity and social contexts of adolescent tuberculosis: a prospective observational cohort study protocol (Teen TB)

Jeremi Swanepoel^{1

2}, Klassina Zimri¹, Marieke M van der Zalm¹, Graeme Hoddinott¹, Megan Palmer¹, Alex Doruyter^{3

4}, Gezila De Beer¹, Leanie Kleynhans⁵, Sarah M Johnson⁶, Vita Jongen⁷, Dillon Wademan¹, Khanyisa Mcimeli¹, Stephanie Jacobs¹, Ruan Swanepoel⁸, Gert Van Zyl⁹, Brian W Allwood¹⁰, Stephanus Malherbe⁵, Charlotte Heuvelings¹, Stephanie Griffith-Richards¹¹, Elizabeth Whittaker⁶, David A J Moore², H Simon Schaaf¹, Anneke C Hesseling¹, James A Seddon^{12

6}

Affiliations

¹ Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
² Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
³ NuMeRI Node for Infection Imaging, Central Analytical Facilities, Stellenbosch University, Cape Town, South Africa.
⁴ Division of Nuclear Medicine, Department of Medical Imaging and Clinical Oncology, Stellenbosch University, Cape Town, South Africa.
⁵ South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, DSI-NRF Centre of Excellence, Stellenbosch University, Cape Town, Western Cape, South Africa.
⁶ Department of Infectious Disease, Imperial College London, London, UK.
⁷ Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, Netherlands.
⁸ Division of Pulmonology, Department of Internal Medicine, Tygerberg Hospital, Cape Town, Western Cape, South Africa.
⁹ Division of Medical Virology, Department of Pathology, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa.
¹⁰ Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa.
¹¹ Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa.
¹² Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa jseddon@sun.ac.za.

PMID: 36600434
PMCID: PMC9772637
DOI: 10.1136/bmjopen-2022-062979

Understanding the biology, morbidity and social contexts of adolescent tuberculosis: a prospective observational cohort study protocol (Teen TB)

Jeremi Swanepoel et al. BMJ Open. 2022.

. 2022 Dec 20;12(12):e062979.

doi: 10.1136/bmjopen-2022-062979.

Authors

Affiliations

¹ Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
² Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
³ NuMeRI Node for Infection Imaging, Central Analytical Facilities, Stellenbosch University, Cape Town, South Africa.
⁴ Division of Nuclear Medicine, Department of Medical Imaging and Clinical Oncology, Stellenbosch University, Cape Town, South Africa.
⁵ South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, DSI-NRF Centre of Excellence, Stellenbosch University, Cape Town, Western Cape, South Africa.
⁶ Department of Infectious Disease, Imperial College London, London, UK.
⁷ Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, Netherlands.
⁸ Division of Pulmonology, Department of Internal Medicine, Tygerberg Hospital, Cape Town, Western Cape, South Africa.
⁹ Division of Medical Virology, Department of Pathology, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, South Africa.
¹⁰ Division of Pulmonology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa.
¹¹ Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, Western Cape, South Africa.
¹² Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa jseddon@sun.ac.za.

PMID: 36600434
PMCID: PMC9772637
DOI: 10.1136/bmjopen-2022-062979

Abstract

Introduction: A considerable burden of the tuberculosis (TB) epidemic is found in adolescents. The reasons for increased susceptibility to TB infection and higher incidence of TB disease in adolescence, compared with the 5-10 years old age group, are incompletely understood. Despite the pressing clinical and public health need to better understand and address adolescent TB, research in this field remains limited.

Methods and analysis: Teen TB is an ongoing prospective observational cohort study that aims to better understand the biology, morbidity and social context of adolescent TB. The study plans to recruit 50 adolescents (10-19 years old) with newly diagnosed microbiologically confirmed pulmonary TB disease and 50 TB-exposed controls without evidence of TB disease in Cape Town, South Africa, which is highly endemic for TB. At baseline, cases and controls will undergo a detailed clinical evaluation, chest imaging, respiratory function assessments and blood collection for viral coinfections, inflammatory cytokines and pubertal hormone testing. At 2 weeks, 2 months and 12 months, TB disease cases will undergo further chest imaging and additional lung function testing to explore the patterns of respiratory abnormalities. At week 2, cases will complete a multicomponent quantitative questionnaire about psychological and social impacts on their experiences and longitudinal, in-depth qualitative data will be collected from a nested subsample of 20 cases and their families.

Ethics and dissemination: The study protocol has received ethical approval from the Stellenbosch University Health Research Ethics Committee (N19/10/148). The study findings will be disseminated through peer-reviewed publications, academic conferences and formal presentations to health professionals. Results will also be made available to participants and caregivers.

Keywords: Paediatric infectious disease & immunisation; Paediatric thoracic medicine; Tuberculosis.

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Conflict of interest statement

Competing interests: None declared.

References

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Understanding the biology, morbidity and social contexts of adolescent tuberculosis: a prospective observational cohort study protocol (Teen TB)

Affiliations

Understanding the biology, morbidity and social contexts of adolescent tuberculosis: a prospective observational cohort study protocol (Teen TB)

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical