The STAMP Study

Improving the treatment of patients with TB and HIV in sub-Saharan Africa.

research-context Context

The brunt of the global AIDS epidemic has been felt in sub-Saharan Africa, with 24.7 million people living with HIV and accounting for 71% of the people living with HIV worldwide. In 2013, there were an estimated 1.1 million deaths due to AIDS in sub-Saharan Africa.

Tuberculosis (TB) is the leading cause of AIDS-related illness and deaths worldwide. 75% of TB cases occur in sub-Saharan Africa. Studies have shown that 30-67% of HIV+ adult patients who die in hospitals are found to have TB. Most of these cases were neither clinically suspected nor diagnosed before death, illustrating a stark failure of current approaches to properly diagnose patients.

The current standard for TB detection in Malawi is a laboratory test called Xpert MTB/RIF. This laboratory test requires a patient sputum sample, and it often takes a few days to return the results to the patient. Several studies have shown fewer than 50% of patients could produce sputum samples when requested.  Furthermore, TB often involves organs other than the lungs and therefore is not always caught using the Xpert test. A new bedside urine-based test has shown promise in increasing the detection of TB. This test, called TB-LAM, can diagnose TB within 30 minutes. While the use of this test has shown increased TB detection, there is no evidence yet that it will reduce HIV-TB mortality. In addition, the cost-effectiveness of this new diagnostic tool has not been shown.

research-aim Aim

To determine whether adding urine testing (using the TB-LAM and Xpert tests) to the routine sputum Xpert test reduces mortality and is cost-effective in TB-HIV co-infected patients.


research-timeline Timeline

March 2015 – October 2017

research-partnerships Partnerships

Funders: UK Department for International Development, Wellcome Trust, UK Medical Research Council
Study Lead: London School of Hygiene and Tropical Medicine (LSHTM)
Partners: University of Malawi – College of Medicine, Edendale Regional Hospital

research-team Study Team

Dr. Stephen Lawn
Principal Investigator, LSHTM

Dr. Joep van Oosterhout
Site-Prinicpal Investigator, Dignitas International

Dr. Melanie Alufandika
Study Physician, Dignitas International

Dr. Ankur Gupta-Wright
International Study Coordinator, LSHTM

Dr. Douglas Wilson
Site-Principal Investigator, Edendale Regional Hospital

research-info Contact

For more info, please email Dr. Joep van Oosterhout at

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