Start4Kids TB project recruits first participant as study opens in Cameroon

Major TB study Start4Kids has recruited its first participant in Cameroon and is now officially open for enrolment.

The project is an extension of Start4All, led by Liverpool School of Tropical Medicine with funding from Unitaid, which focuses on the global improvement of tuberculosis (TB) screening, diagnosis and treatment.

Start4Kids acknowledges that children are at a higher risk of dying from TB in comparison to adults with the disease highlighting the importance of improving both diagnosis and linkage to timely care.

Diagnosing TB in children remains particularly challenging – obtaining suitable samples and limited access to sensitive diagnostic tools close to where children receive care can contribute to delays in diagnosis and treatment.

Dr Rachel Byrne, Principal Investigator of Start4Kids at LSTM, said: “Children remain underserved by many of the advances being made in TB diagnostics.

“Through Start4Kids, we aim to fill important policy and evidence gaps so that new, more effective diagnostic tools can be made accessible to children and brought closer to the settings where children seek care.”

Improving diagnosis

Start4Kids will evaluate innovative approaches to improve the diagnosis of TB in children by bringing diagnostics closer to the facilities where children receive care.

The study will assess novel near-point-of-care diagnostic technologies alongside tools such as computer-aided detection (CAD) of chest X-rays.

By testing how these technologies work in routine healthcare settings, Start4Kids will generate evidence on how they could support earlier and more accessible diagnosis of childhood TB and inform their future introduction and scale-up.

Evidence to guide policy

Dr Rita Nsamenang, a clinical researcher from Bamenda Centre for Health Promotion and Research, a collaborating partner in Start4Kids, said: “In Cameroon, diagnosing tuberculosis in children continues to rely primarily on clinical assessment.

“As part of our mission to bridge the diagnosis gap, we are delighted to initiate participant recruitment in the Start4Kids study. This moves us closer toward generating evidence that will help guide policies here in Cameroon and in other high TB burden countries.”

Smiljka de Lussigny, Programme Manager at Unitaid, added: “For too long, children have been an afterthought when it comes to health innovation. Many transformative tools have reached the market ready for adults, while children were left waiting for the evidence and adaptations needed to benefit from them.

“At Unitaid, we are committed to changing that by prioritising investments to ensure innovations are accessible to children. Through Start4Kids, we are proud to continue generating the evidence needed to close the TB diagnostic gap.”

Recruitment will now continue in Cameroon, with additional study sites in other countries expected to open in the coming weeks.

Start4Kids is supported by Unitaid as part of its broader work to expand access to innovative TB diagnostics for underserved populations.

Building on the work of the Start4All consortium, the study brings together countries, researchers and implementation partners to generate evidence that can support the future introduction of child-friendly diagnostic solutions.

Tuberculosis research and education

Liverpool School of Tropical Medicine provides postgraduate and continuing professional development in tuberculosis education including: MSc One Health in Tropical and Infectious Disease; essentials of TB epidemiology, clinical management and control; and combined essentials of TB and HIV.

LSTM’s Centre for Tuberculosis Research builds on decades of expertise in TB research and control, driving innovation from laboratory discovery to field implementation to accelerate progress towards ending TB.