Stream Community Engagement

Stream Community Engagement Community engagement is an essential part of the STREAM trial and acknowledges the importance of The Good Participatory Guidelines for TB Drug Trials.

STREAM community engagement creates opportunities for dialogue and cooperation among stakeholders. The STREAM clinical trial is testing the effectiveness of shortened treatment regimens for multidrug-resistant tuberculosis (MDR-TB). STREAM Stage 1 is evaluating a nine-month shortened treatment regimen against the standard 20 to 24-month treatment regimen. Stage 2 of STREAM studies two additional regimens: an all-oral nine-month regimen and a six-month regimen, both of which include the novel anti-TB medicine bedaquiline. Clinical research needs to fulfil the health-related needs of the community and, as such, community structures should always be considered when trials are implemented. In addition, members of communities involved in the trial need to understand the research itself, as well as ethics and regulatory requirements. To achieve this in a meaningful way, a structure of communication needs to be established through community engagement. The STREAM trial has developed a community engagement plan to facilitate that communication structure. The STREAM trial is being implemented by The International Union Against Tuberculosis and Lung Disease and its affiliate Vital Strategies. Stage 1 of the STREAM Trial was funded primarily through the TREAT TB cooperative agreement with the US Agency for International Development (USAID), with additional funding from the UK Medical Research Council and the UK Department for International Development (DFID). STREAM Stage 2 is jointly funded by USAID and Janssen Pharmaceuticals.

Many lessons were learned about community engagement in the  . CABs documented their experiences with CE and   developed...
06/30/2021

Many lessons were learned about community engagement in the . CABs documented their experiences with CE and developed practical recommendations designed to improve community engagement in future clinical trials.

To read the practical recommendations from CE in the STREAM clinical trial, click here: https://streamrecommendations.treattb.org/

To read Community Engagement Lessons Learned: A Community Perspective, click here: https://www.vitalstrategies.org/resources/community-engagement-lessons-learned-a-community-perspective/

USAID - US Agency for International Development
Vital Strategies International Union Against Tuberculosis and Lung Disease (The Union)
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STREAM is a multi-country clinical trial evaluating shorter, more tolerable regimens for multidrug-resistant tuberculosis. This site offers practical recommendations drawn from the lessons learned over the course of the trial.

All   participants have now completed their allocated trial treatment, paving the way for preliminary trial results to b...
01/27/2021

All participants have now completed their allocated trial treatment, paving the way for preliminary trial results to be reported in 2022. Thank you to our implementing partners and trial participants, who played a critical role in achieving this important milestone. USAID - US Agency for International Development Vital Strategies Medical Research Council

Last week, the STREAM clinical trial reached a significant milestone, when the last-recruited participant completed their allocated trial treatment regimen. A total of 588 participants at 13 sites were recruited to Stage 2 of the trial, which is expected to report results in 2022. The aim of Stage 2...

12/23/2020

Last month, STREAM Community Advisory Boards (CABs) from seven countries joined the eighth STREAM All-CAB webinar to learn more about ethical principles related to research, and their impact on the roles and responsibilities of key stakeholders. The webinar focused on how communities can ensure thei...

Subrat Mohanty, India’s Community Engagement Coordinator for the  , will be leading the   Community Connect on "TB Champ...
10/22/2020

Subrat Mohanty, India’s Community Engagement Coordinator for the , will be leading the Community Connect on "TB Champions respond to COVID-19: Narratives from India" tomorrow from 11:30-12:15 CEST. To join the session, please click here: https://worldlunghealth2020.theunion.org/session/tb-champions-respond-to-covid-19-narratives-from-india

USAID - US Agency for International Development The Union World Conference on Lung Health Medical Research Council

The COVID-19 pandemic limited access to TB services across India. This was reflected in Nikshay data, media reporting and reports by TB advocates showing that TB case notification had declined considerably and loss to follow up cases had surged. COVID-19 presented new challenges for healthcare provi...

10/22/2020

In Stage 1 of the , severe QT prolongation was more frequent on the short regimen. This could have been due to high dose moxifloxacin and clofazamine used in the short regimen. At the conference, Gareth Hughes from Medical Research Council reported the results of further analyses of Stage 1 data to explore whether there was a cut-off value that could allow prioritization of ECG monitoring. Results suggest that using a combination of cut-offs might permit a reduction in ECG monitoring frequency in 47% of patients on the short regimen. These results need further validation but could potentially be useful in programmatic settings with limited resources.
USAID - US Agency for International Development The Union World Conference on Lung Health

10/22/2020

Vital Strategies’ team investigated the sensitivity and specificity of tablet-based audiometry compared to conventional audiometry in Stage 2 of the . Vital Strategies’ Pharmacist, Ishmael Qawiy, presented a poster on our findings, which suggested tablet-based audiometry was a sensitive tool for detecting hearing loss and an effective way to monitor clinical trial participants. Tablet-based technology is important for improving access to audiometry testing in low resource settings and should be considered in settings where conventional audiometry is limited or unavailable. USAID - US Agency for International Development The Union World Conference on Lung Health Medical Research Council

10/22/2020

At the , Laura Rosu, partner and researcher from LSTM, reported that the short-regimen for MDR-TB evaluated in Stage 1 of the reduced health system costs by 20–25%, and was associated with an earlier return to work and a reduction in the purchase of supplementary food. The results also indicate that men spent more on supplementary food than women in both arms of the trial. This disparity should be considered by policy makers when devising packages to address TB patient costs. USAID - US Agency for International Development The Union World Conference on Lung Health Medical Research Council

Vital Strategies Ishmael Qawiy presents data on tablet-based audiometry compared to conventional audiometry in Stage 2 o...
10/22/2020

Vital Strategies Ishmael Qawiy presents data on tablet-based audiometry compared to conventional audiometry in Stage 2 of the . Head to the portal to hear his presentation! USAID - US Agency for International Development The Union World Conference on Lung Health Medical Research Council

*Please scroll down for more information* 12:30 - 12:35: Introduction 12:35 - 12:43: OA-17-605-22-Audiometry outcomes during and after drug-resistant TB treatment with a kanamycin-containing drug-regimen: drug-resistant TB patients assessed in three rural districts of Masvingo Zimbabwe The abstract....

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The STREAM clinical trial is testing the effectiveness of shortened treatment regimens for multidrug-resistant tuberculosis (MDR-TB). STREAM Stage 1 evaluated a nine-month shortened treatment regimen against the standard 20 to 24-month treatment regimen. Stage 2 of STREAM studies an additional all-oral nine-month regimen that includes the novel anti-TB medicine bedaquiline. Clinical research needs to fulfil the health-related needs of the community and, as such, community structures should always be considered when trials are implemented. In addition, members of communities involved in the trial need to understand the research itself, as well as ethics and regulatory requirements. To achieve this in a meaningful way, a structure of communication needs to be established through community engagement. The STREAM trial has developed a community engagement plan to facilitate that communication structure. The STREAM trial is being implemented by Vital Strategies and its affiliate The International Union Against Tuberculosis and Lung Disease. Stage 1 of the STREAM Trial was funded primarily through the TREAT TB cooperative agreement with the US Agency for International Development (USAID), with additional funding from the UK Medical Research Council and the UK Department for International Development (DFID). STREAM Stage 2 is jointly funded by USAID and Janssen Pharmaceuticals.