Nurse-led care for rifampicin-resistant TB in community clinics versus doctor-led hospital care
The Bring BPaL2Me Trial - Comparing Nurse-Led RR-TB Treatment in Primary Care to Physician-Led, Hospital-Based RR-TB Treatment: A Cluster Randomized, Non-Inferiority Trial
This project compares nurse-led rifampicin-resistant TB treatment in community clinics to doctor-led hospital care for people with drug-resistant TB, many of whom also have HIV.
Quick facts
| Grant type | R01 grant |
|---|---|
| Study type | NIH-funded research |
| Funding institution | Johns Hopkins University NIH-funded |
| Lab location | 1 site (Baltimore, United States) |
| Project ID | NIH-11403845 on NIH RePORTER |
What this research studies
This multi-site trial in South Africa randomizes primary care clinic clusters to nurse-led management of rifampicin-resistant TB or to the standard physician-led hospital outpatient model. About 50 clusters across KwaZulu-Natal, Gauteng, and Eastern Cape aim to enroll roughly 2,944 participants after screening ~3,800 people with RR-TB. Most participants are expected to be HIV co-infected, and care in the clinic arm is integrated with routine HIV services. The trial tests whether decentralized, nurse-led care can keep outcomes no worse than standard hospital-based care while reducing patient costs and improving access.
Who could benefit from this research
Good fit: Adults diagnosed with rifampicin-resistant TB (many with HIV) who can attend participating primary care clinics or are referred from district hospitals in KwaZulu-Natal, Gauteng, or Eastern Cape are the intended candidates.
Not a fit: People without rifampicin-resistant TB, those who need inpatient hospitalization for severe illness, or individuals living outside the participating provinces are unlikely to benefit directly from this project.
Why it matters
Potential benefit: If successful, people with rifampicin-resistant TB could receive effective, lower-cost treatment at local clinics with better integration of HIV care.
How similar studies have performed: Nurse-led, decentralized care has matched hospital outcomes for drug-susceptible TB in South Africa, but nurse-led management specifically for rifampicin-resistant TB has been less widely tested and remains not fully proven.
Where this research is happening
Baltimore, United States
- Johns Hopkins University — Baltimore, United States (Active)
Researchers
- Principal investigator: Farley, Jason Edward — Johns Hopkins University
- Study coordinator: Farley, Jason Edward
About this research
- This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
- Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
- For full project details, budget, and progress reports, visit the official NIH RePORTER page below.