Ethiopia is one of 30 high TB, TB/HIV, and MDR-TB burden countries in the world, according to the WHO. In 2017, estimated incidence for TB was 164 per 100 000 population and the mortality rate was 27.5 per 100 000 population. In 2017, 117,705 TB cases were notified. It is also estimated that 2.7% of new cases and 14% of previously treated cases were MDR /RR-TB. In 2015, MDR/RR-TB treatment was initiated in 660 patients, of which 75% were successfully treated.
For STREAM Stage 1, 126 patients were enrolled at two sites in Addis Ababa, Ethiopia. A total of 55 patients were enrolled at the Armauer Hansen Research Institute (AHRI) and 71 patients were enrolled at St. Peter’s Tuberculosis Specialized Hospital (St. Peter’s).
Given the successful implementation of Stage 1 in Ethiopia, the same sites were chosen to participate in Stage 2 of the trial. Ethiopia was the second country to initiate STREAM Stage 2 and began recruitment in June 2016. The two sites are expected to complete recruitment in late 2019 and recruit more than 70 participants for Stage 2.
AHRI was established by the Norwegian and Swedish Save the Children organizations seconded by the Ministry of Health in Ethiopia in 1970. It was built as a biomedical research institute next to the All Africa Leprosy Rehabilitation and Training Hospital and joined the Ministry of Health in 2003. It is dedicated to better understanding tuberculosis and leprosy through basic biomedical research. AHRI seeks to develop evaluation capacity and build expertise for new methods of TB prevention, treatment, and control in the Horn of Africa.
St. Peter’s was established in 1953 as part of the Ministry of Health of the Federal Democratic Republic of Ethiopia. Its mission is to become a center of excellence and a model TB specialized hospital in East Africa. Its objectives are to integrate internal medicine and pediatrics services; to train laboratory scientists and nurses; and to improve research, training, and health services. St. Peter’s offers a host of services including health facility-based medical care, laboratory services, psycho-social support, and community education. It also conducts HIV/AIDS research.