Ongoing

SCAF-TB

Saving Children And their Families from TB.

Central to SCAF-TB is the belief that sustainable TB prevention must be rooted in local communities.

Background

Tuberculosis (TB) remains one of the top 10 causes of death globally, with an estimated 10.8 million people developing TB and 1.25 million deaths in 2023, including over 200,000 children. Investigating TB among household contacts of people with TB is a key strategy for preventing further transmission and reducing disease burden. Despite global commitments to expand TB preventive treatment (TPT), uptake remains critically low, particularly among children and their family members in high TB-burden countries.

In Tanzania, over 122,000 people lived with TB in 2023, including 20,000 children. Only 16% of eligible household contacts received TPT. In Tajikistan, where TB is still the leading infectious cause of death, TPT coverage reached just 52% among contacts, far below national targets.

Several challenges hinder TPT uptake: 

  • Limited access to accurate and affordable TB infection (TBI) testing in low-resource settings.
  • Diagnostic limitations of current tools like the TST and IGRA.
  • Stigma and fear around giving treatment to asymptomatic children.
  • Repeated clinic visits that are costly and inconvenient for families.
  • Difficulty in ruling out TB disease before starting TPT.

SCAF-TB, short for Saving Children And their Families from TB, was launched to address these gaps through innovative, community-led approaches that bring TB preventive services directly to households.

About SCAF-TB

SCAF-TB is a multi-country implementation research project focused on overcoming barriers to TB prevention and early detection.

Aim 

SCAF-TB aims to create a scalable, cost-effective, and family-centred model for TB prevention and early detection in high-burden settings. By addressing critical gaps in TPT implementation, the project seeks to:

  • Reduce the number of people developing TB disease.
  • Interrupt community-level transmission.
  • Generate real-world evidence to inform national and global TB policy.
  • Strengthen health system capacity for long-term sustainability.
  • Integrate innovative tools for TB screening and TBI testing.

Innovation

The project will field-test five innovative, community-led strategies that optimize:

  • Early case finding.
  • TBI testing.
  • TPT delivery.

All strategies are designed to be family-centred, equitable, and sustainable. 

We will work closely with community leaders, civil society organizations (CSOs), healthcare workers, and national TB programs in Tanzania and Tajikistan to generate robust evidence for scale-up and inform national and global TB policies. Innovations include: 

  • Simplified, reliable TBI diagnostic tools (SIILTIBCY).
  • AI-assisted reading of TBI testing results.
  • Cough application for early case detection.
  • Advancing short (child-friendly) TPT regimens.
  • Shifting TPT services (testing, dispensing, counseling) to the community level.

The project emphasizes open access and data transparency, adhering to FAIR principles (Findable, Accessible, Interoperable, Reusable). All data will be anonymized and compliant with GDPR and EU data protection standards.

Expected impact of SCAF-TB

  • Increased uptake and completion of TPT among household contacts, especially children.
  • Improved access to simplified, community-based TB infection testing.
  • Enhanced community awareness and acceptance of TPT.
  • Strengthened surveillance and reporting systems at local and national levels.
  • Evidence-based tools and policies ready for national scale-up and global adoption.
  • By shifting TB prevention closer to the people who need it most, SCAF-TB will help reduce TB incidence and save lives, especially among vulnerable children. 

Funding and Partners

SCAF-TB is funded by the Johnson & Johnson Charity Account managed by the King Baudouin Foundation (Belgium) and implemented with NTPs of Tanzania and Tajikistan by KNCV TB Plus, with support from MyLab for AI-assisted TBI testing and RAIsonance for digital screening technologies.

If you want to know more about SCAF-TB, please contact Christiaan Mulder: