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OPTIC-TB

Every year, about a million children under 15 years are diagnosed with Tuberculosis (TB) worldwide, and about a quarter die. However, over 60% of children with TB remain undiagnosed, particularly in sub-Saharan Africa, which accounts for about 20% of the global burden of paediatric TB cases. Challenges in specimen collection in young children, which often require trained and experienced staff, difficulty in diagnosis, the perceived low risk of transmission and the lack of laboratory infrastructure contribute to low TB detection in children in this region.

Group photo. Persons lined opp on a green lawn with a poster at each end promoting the project. Palm trees in the background.
Photo: Eric Alam

Affiliation

Duration

–

About the research project

Full project title: Optimizing Childhood TB Treatment Decision Algorithms in sub-Saharan Africa - OPTIC-TB.

 

Summary of the project 

In 2022, the World Health Organization (WHO) issued an interim recommendation to use integrated Treatment-Decision Algorithms (TDAs) to diagnose TB in children under ten years. However, this recommendation was based on very low certainty of evidence. Therefore, our project, which will be conducted in Tanzania, Uganda and DR. Congo aims to address four objectives: 

  1. To compare the effectiveness of TDAs and the Standard of Care in routine clinical settings  
  2. To identify processes and contextual factors that influence the effectiveness and fidelity in the implementation of TDAs  
  3. To compare the costs, cost-effectiveness and the population-level impact of TDA strategies on the burden of TB  
  4. To validate the diagnostic performance (sensitivity, specificity, negative and positive predictive values) of the TDAs in various health system settings and clinical context 
Infographic highlights tuberculosis (TB) statistics in Sub-Saharan Africa (SSA) for 2022, showing 33% of global childhood TB deaths occurred in SSA and 30% of childhood TB cases in SSA remain undiagnosed. The design features red background, white text, a map of Africa with SSA countries highlighted in red, and logos of supporting organizations at the bottom.
Photo: OPTIC-TB

Partners and project leaders

(ºÚÁϳԹÏ×ÊÔ´), Norway (coordinator)
, (NIMR), Tanzania
(UCB), Democratic Republic of Congo
(KIUT), Tanzania
, (MULI), Uganda
(KIU), Uganda

Dr. Amani Thomas Mori (ºÚÁϳԹÏ×ÊÔ´) (project coordinator)
Prof Sayoki Mfinanga (NIMR) 
Prof Patrick de marie Katoto (UCB) 
Prof Bruce Kirenga (MULI) 
Prof Angwara Kiwara (KIUT) 
Prof Andrew Kitua (KIU)

Design, hypothesis and outcomes, Impact

Design
A four-year pragmatic open-label cluster randomized controlled trial will be conducted in 120 primary health facilities in the three countries. About 60,000 children with presumptive TB visiting the health facilities will be screened and those fulfilling the criteria will be enrolled in the study. 

Hypothesis and outcomes 
We hypothesize that the WHO-recommended TDA strategy is superior to the standard of care (SOC) in (i) increasing by at least 20%, the proportion of children below 10 years with pulmonary TB detected and initiated on TB treatment and (ii) improve the proportion of children with pulmonary TB with good TB treatment outcome in the intervention facilities compared to the Standard of Care. 

Impact
We anticipate that this project will yield results that address the issue of low detection of paediatric TB in sub-Saharan Africa and beyond, build research capacity in conducting implementation research in low- and middle-income countries and foster networking and collaboration between the partner institutions. 

Work packages

  • WP1 Project Management & Coordination - ºÚÁϳԹÏ×ÊÔ´
  • WP2 Effectiveness assessment, costing/cost effectiveness and impact evaluation - NIMR
  • WP3 Performance validation, feasibility and accetability studies - MULI
  • WP4 Dissemination, Communication and networking - UCB
  • WP5 Data Management, economic and statistical analysis - NIMR
  • WP6 Mentorship and Capacity Building - KIUT
  • WP7 Ethics requirements - ºÚÁϳԹÏ×ÊÔ´
  • WP8 Scientific project leadership - NIMR

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Featured

  • Photograph of a large group of people posing outdoors near a coastal area with ocean and palm trees in background. Group appears to be celebrating or greeting, with many individuals raising hands, dressed in business casual attire, surrounded by greenery and outdoor structures.

    OPTIC-TB 2nd Annual General Meeting

  • Photograph of a group of six people in a room with white walls and a tiled ceiling, where five are seated on blue plastic chairs and one stands holding a paper with diagrams. One person stands, and explains guidelines printed on a document, in a training session for health care personell.

    OPTIC-TB: Field report from HGR Nyangezi/Muzinzi, DRC March 2026

  • Photograph of a classroom or seminar setting with a woman in a yellow blazer speaking to an audience seated at desks. The room features a large projection screen displaying text, with attendees engaged and various items like water bottles and laptops on desks.

    OPTIC-TB: Refresher training in Tanzania, January 2026

  • Photograph showing a person on a heavily loaded motorcycle crossing shallow water near a shore, with a white off-road vehicle partially submerged in the background. The scene highlights challenges of transportation in rugged, watery terrain, featuring colorful bags on the motorcycle and clear water revealing rocky bottom.

    OPTIC-TB: Challenges on the way in remote facilities in DRC October 2025

All featured articles

People

Project manager

Amani Mori Project coordinator, senior researcher

Funding

  • European Research Council (ERC)

The project is supported by the EDCTP3 and its members. Funded by the European Union. Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or Horizon Europe/EDCTP3. Neither the European Union nor the granting authority can be held responsible for them.