Recurrent TB screening & prevention

Preventing the return of TB

RECENT-TB is exploring whether a short course of antibiotics taken after TB treatment can prevent disease recurrence and how this could be targeted at those who would benefit most.

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Study Duration
2026 – 2030
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Study Sites
Uganda & South Africa
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Funded by
Global Health EDCTP3
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In collaboration with
National TB programmes
Randomized trial
People treated for TB may experience recurrence within two years
Implementation Evidence
Being evaluated for recurrence risk.
Costing Study
Effectiveness + implementation evidence.
Case-Control Study
Evidence for practical secondary prevention.
THE CHALLENGE

Why recurrence after TB treatment matters

Around one in ten people who successfully complete TB treatment experience relapse or reinfection within two years. RECENT-TB addresses this relatively neglected period after treatment.

01

Recurrence remains common

Every year, around 1.5–2 million people in sub-Saharan Africa are treated for TB, and recurrence contributes a substantial share of the TB burden.

02

Prevention may help

Secondary preventive treatment is already used in selected high-risk groups, but evidence for wider use is still limited.

03

Targeting is important

Risk stratification may allow preventive treatment to be directed to those most likely to benefit rather than offered to everyone.

The project

Testing prevention and identifying who is most at risk.

The RECENT-TB trial is a hybrid effectiveness- implementation trial. The main trial will recruit 1,806 participants who have completed treatment for pulmonary TB. Half (903  participants) will receive 12 weekly doses of isoniazid + rifapentine (3HP) while the other half will not. All participants will be followed up for 2 years after enrolment. 

Embedded studies will evaluate if simple blood tests can predict who is most at risk for developing recurrent TB, collect implementation and costing data to inform porential scale up and evaluate the diagnostic performance of a new test (TB-MBLA) for the diagnosis of recurrent TB. 

98
Participants targeted for the main trial (903 per arm)
0 year
Participant follow-up after enrolment
0 HP
12 weekly doses of isoniazid + rifapentine
0
Candidate risk markers evaluated
What RECENT-TB is doing

Research designed for real-world impact

RECENT-TB combines clinical research, implementation and costing evidence to inform future TB policy and practice.

01

Prevent recurrence

Determine whether secondary TB preventive treatment with 3HP reduces TB recurrence after
successful treatment.

02

Identify persons at higher risk of recurrence

Evaluate simple clinical markers and develop a personalised risk assessment that could be used to select persons for secondary TB preventive therapy

03

Support scale-up

Generate implementation and costing evidence to help national TB programmes consider secondary prevention in policy and practice.

Study overview

Research designed for real-world impact

The project combines a large clinical trial, evaluation of clinical markers for risk prediction, a diagnostic accuracy study, as well as implementation research, and economic evaluation.

Sub study 1

Identifying persons at higher risk of recurrence

.Evaluate simple clinical markers and develop a personalised risk assessment that could be used to select persons for secondary TB preventive therapy

Sub study 2

Evaluate diagnostic accuracy of new diagnostics

Determine the accuracy of a new diagnostic test (TB MBLA) for the diagnosis of recurrent TB

Sub study 3

Support scale-up

Generate implementation and costing evidence to help national TB programmes consider secondary prevention in policy and practice.

A randomized controlled trial with 3 embedded sub studies

Main Study

1

Recruit

 Enroll people after treatment for pulmonary TB.

2

Randomise

 Half receive 3HP, 12 weekly doses of isoniazid plus rifapentine. Half will not receive 3HP

 

3

Follow

Follow-up participants for two years with periodic testing to assess recurrence and implementation outcomes.

4

Translate

 Use results to inform policy, practice, targeting approaches, and future scale-up.

Risk markers

Simple tests that may help predict who is most at risk.

 RECENT-TB is collecting data on four potential markers and evaluating how well they predict recurrence.

CRP

 Finger-prick inflammation test

Haemoglobin

Point-of-care anaemia test

CXR + CAD4TB

Computer-aided chest X-ray interpretation

TB-MBLA

Molecular detection of live TB bacteria

How the main trial works

From treatment completion to two years of follow-up.

1

Recruit

 Enroll people after treatment for pulmonary TB.

2

Randomise

 Half receive 3HP, 12 weekly doses of isoniazid plus rifapentine.

3

Follow

 Track participants for two years to assess recurrence and implementation outcomes.

4

Translate

 Use results to inform policy, practice, targeting approaches, and future scale-up.

Community first

The trial emphasizes respectful and continuous community engagement. Community members should understand the study, their rights and what to expect when they enroll into the study.

Participant-facing content area for FAQs, eligibility, procedures, confidentiality, and Community Advisory Board updates.

Community section

Information people can use

Participant FAQs

 Eligibility, study duration, procedures, rights and confidentiality

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Community Advisory Board (CAB) updates

 CAB updates and plain-language meeting notes.

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Study contacts

 Clear routes for participant questions and feedback.

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Study updates

A record of progress

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Enrollment milestones

Share progress as the study reaches key recruitment and follow-up targets.
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Meetings & training

Publish plain-language summaries from consortium, CAB, TSC and IAB meetings, plus study-team training highlights.

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Evidence & resources

Host policy briefs, interim and final reports, and links to the project’s scientific repository.
LATEST FROM X

Follow Us on X.

Study milestones, training highlights, consortium updates and community engagement can appear here automatically from the project’s official X account
@RECENT_TB
LIVE FEED

Replace @IDIMakerere with the official RECENT-TB X handle before public launch.

LATEST FROM X

Follow Us on X.

Study milestones, training highlights, consortium updates and community engagement can appear here automatically from the project’s official X account
@RECENT_TB
LIVE FEED

Replace @IDIMakerere with the official RECENT-TB X handle before public launch.

People behind the study

Study Team

A multidisciplinary team of researchers, clinicians and public-health experts working with national TB programmes and collaborating institutions.
Study Coordination
RECENT-TB consortium
RECENT-TB consortium — international scientific and operational leadership.
Uganda Team
Scientific leadership
Infectious Diseases Institute, Uganda — scientific leadership
South Africa Team
Site investigators
Stellenbosch University — clinical and implementation research partners.
Community & Policy
Engagement partners
Engagement partners working with communities and national TB programmes.
Partnerships

Our Collaborators

RECENT-TB is coordinated internationally, with scientific leadership in Uganda and collaboration across participating sites and national TB programmes.
IDI
INFECTIOUS DISEASES INSTITUTE · UGANDA
Amsterdam UMC
Makerere University
University of Cape Town
To Add Another One

Funded by the Global Health EDCTP3 programme.
RECENT-TB is designed to generate evidence on secondary prevention of TB, implementation considerations, risk stratification and cost-effectiveness to help inform future policy and practice.