Our goal

Our goal is to increase the capacity of the Clinical Prevention Services division for conducting applied research that is of the highest quality and leads to practice and policy change in BC, Canada and internationally.

Our objectives

Our objectives are:

• To attract new research funding
  
• To support efficient research practices
  
• To attract and support trainees
  
• To translate research into action
  
• To increase our online presence
• To provide mentorship and skills building for researchers in CPS
  

Anxious client presentations in online sexual health encounters: We are currently conducting research to understand how to better serve sexual health clients who present with high levels of anxiety or worry about HIV and other sexual health concerns.

• A survey of 1,115 sexual health clinic clients, measuring unmet mental health care needs | read more 
  
• Interviews with sexual health providers and administrators exploring how they address clients’ mental health needs | read more 
  
• Assessments of points of healthcare access for sexual minorities with particular mental health service need | read more 
  

DiSHI: Research about the impact of online and other digital public health interventions, such as GetCheckedOnline and SmartSexResource, on sexual health at the individual, system and population levels | Read more

DaDHS: A prospective, double-blind, randomized, controlled multi-centre pilot trial of daily doxycycline versus placebo for the prevention of syphilis among gay, bisexual, men who have sex with other men (gbMSM) living with HIV | Read more

DISCO: The first methodologically rigorous randomized controlled trial ( three-arm trial), investigating the use of doxycycline in the prevention of bacterial STIs (syphilis, gonorrhea, or chlamydia) among gay, bisexual and other men who have sex with men (both cisgender and transgender) or transgender women | Read more

Syphilis PrEP (DuDHS): A randomized trial of doxycycline in syphilis prevention among gay, bisexual and men who have sex with men. The study assess the suitability of using dual daily HIV and syphilis PrEP and medication adherence.

Street Youth Video Project: A research project in collaboration with the Public Health Agency of Canada aimed at exploring issues in the life of street youth that contribute to the risk of contracting sexually transmitted infections including AIDS. At the end of the project, the youth engaged in the project developed video clips with the help of a local film agency to tell their stories around sexual risk while living on the street and some of the research findings. | Watch Carter's story & Trevor's story

HPV-SAVE (RCT Study): A randomized controlled trial of ablative treatment versus observation alone for high grade anal dysplasia | Read more

We aim to perform research that informs TB elimination activities and high-quality clinical care for people affected by TB in British Columbia (BC). Below is a list of select research projects performed by our team in collaboration with national and international collaborators.

Cohort studies

TB-MIGRATE: We are developing (BC) and validating (Ontario) a TB risk prediction calculator in people that migrate to BC using health administrative and disease registry data. Outputs from this project will improve epidemiological and economic modelling of TB elimination activities.

Funding: Canadian Institutes of Health Research; Health Research BC; TB Vets

Status: ongoing

FOLLOW-TB: This multicentre, prospective cohort aims to understand the costs and health consequences of TB infection and disease throughout a person's treatment and post-treatment period. The outputs will help us understand the true health and financial "costs" of TB.

Funding: National Sanitorium Association

Status: enrolling in BC in Fall 2024

Randomized Controlled Trials

ASTERoiD (TBTC Study 37): The Asteroid study is multinational randomized controlled trial evaluating a six-week TB preventive therapy regimen of daily rifapentine compared to 12-16 weeks of rifamycin-based therapy.
Funding: US Dept of Health and Human Services (CDC TBTC Network)

Status: enrolling

CRUSH-TB (aka TBTC Study 38): The CRUSH study is a phase 2C clinical trial of novel, short course regimens for the treatment of pulmonary tuberculosis.

Funding: US Dept of Health and Human Services (CDC TBTC Network)

Status: starting enrolment in BC in summer 2024

FLIRT trial: This phase 3, international, multicentre, double-blind randomized controlled trial aims to generate high quality evidence for treatment of isoniazid resistant TB. This study will evaluate the effectiveness of a levofloxacin-based intervention (2LREZ/4LR) versus 6REZ.
Funding: Australian MRC
Status: starting enrolment inn BC in summer 2024

2R2 trial

This phase 2 trial compared two novel 'ultra-short' course high dose rifampin regimens to standard of care for tuberculosis preventative therapy. Safety outcomes in Lancet Respiratory Medicine with follow-up ongoing for efficacy outcomes.

Funding: Canadian Institutes of Health Research

Status: enrolment complete, participant follow-up ongoing

DESCRIPTIVE EPIDEMIOLOGY OF TB IN BC AND CANADA

Jordan AE, Nsengiyumva NP, Houen RM, et al. The prevalence of tuberculosis infection among foreign-born Canadians: A modelling study. CMAJ 2024 195(48):E1651-1659.

Campbell JR, Nsengiyumva, Chiang L, et al. Costs of tuberculosis at three Canadian centres: a retrospective study. Emerging Infectious Diseases 2022; 28(9):1814-1823.

Puyat JH, Shulha HP, Balshaw R, et al. Law S, Menzies R, Johnston JC. How well does TSTin3D predict risk of active tuberculosis in the Canadian immigrant population? An external validation study. Clin Inf Dis. 2021 73(9):e3486-3495.

Ronald LA, Campbell JR, Balshaw RF, et al. Demographic predictors of active tuberculosis in people migrating to British Columbia. Canada: a retrospective cohort study. CMAJ. 2018 February 26; 190(8): E209-E216

Romanowski K, Sobkowiak B, Guthrie JL, et al. Using whole-genome sequencing to determine the timing of secondary tuberculosis in British Columbia, Canada. Clinical Infectious Diseases. 2021. 73(3):535-537

POST-TB OUTCOMES

K Romanowski, VJ Cook, M Gilbert, JC Johnston. Using a theory-informed approach to guide the initial development of a post-tuberculosis care package in British Columbia, Canada. 2023; BMC Health Services Research 23 (1), 805

Romanowski K, Amin P, Johnston JC. Improving Post-Tuberculosis Care in Canada. Canadian Medical Association Journal 2023; 195(5): e217-e219.

Romanowski K, Law MR, Karim ME, et al. Healthcare utilization after respiratory tuberculosis: a controlled interrupted time series analysis. Clinical Infectious Diseases. 2023 77(6):883-891.

Romanowski K, Baumann B, Basham CA, et al. Long-term all-cause mortality in people treated for tuberculosis: a systematic review and meta-analysis. The Lancet Infectious Diseases. 2019; 19(10): 1129-1137.

Basham CA, Romanowski K, Johnston, JC. Life after tuberculosis: planning for health. The Lancet Respiratory Medicine. 2019 October 29; 7(12):1004-1006.

Basham CA, Karim ME, Cook VJ, et al. Post-tuberculosis mortality risk among immigrants to British Columbia, Canada, 1985–2015: a time-dependent cox regression analysis of linked immigration, public health, and vital statistics data. Canadian Journal of Public Health. 2020 Jul 14; 112(1): 132-141.

Basham CA, Karim ME, Cook VJ, et al. Post-tuberculosis airway disease: a population-based cohort study of people immigrating to British Columbia, Canada, 1985-2015 . E clinical Medicine. 2021 February 26; 33: 100752

Basham CA, Karim ME, Cook VJ, et al. Tuberculosis associated depression: a population –based cohort study of people immigrating to British Columbia, Canada, 1985-2015. Annals of Epidemiology 2021; 63:7-14.

RANDOMIZED CONTROLLED TRIALS

Ruslami R, Fregonese F, Apriani L, et al. High-dose, short-duration versus standard rifampicin for tuberculosis preventative treatment: a partially blinded, three-arm, non-inferiority, randomized, controlled trial. The Lancet Respiratory Medicine 2024.

Menzies D, Obeng J, Hadisoemarto P, et al. Sustainability and impact of an intervention to improve initiation of tuberculosis preventative treatment: results from a follow-up study of the ACT4 randomized trial. EclinicalMedicine. 2024(71)

Oxlade O, Benedetti A, Adjobimey M, et al. Effectiveness and cost-effectiveness of a health systems intervention for late tuberculosis infection management: a cluster randomized trial. Lancet Pub Health. 2021 6(5):e272-282.

Menzies D, Adjobimey M, Ruslami R, et al. Four months of rifampin or nine months of isoniazid for latent tuberculosis in adults. NEJM 2018; 379:440-453.

Diallo T, Adjobimey M, Ruslami R, et al. Safety and side effects of rifampin versus isoniazid in Children. NEJM 2018; 379:454-463.

Johnston JC, Van Der Kop ML, Smillie K, et al. The effect of text messaging on latent tuberculosis treatment adherence: a randomised controlled trial. Eur Resp J. 2018 February 7; 51(2): 1701488. 

• Enhancing the public health impact of latent TB infection diagnosis and treatment (ACT4): A pragmatic cluster randomized trial in Canada, Benin, Ghana, Indonesia and Vietnam to evaluate the effectiveness of a standardized public health evaluation followed by targeted solutions for problems identified on increasing the proportion starting latent TB infection treatment among household contacts of patients with active pulmonary TB
• WelTel Outreach: Engaging clients in the field: A project that generates evidence for better communications and delivery of TB care throughout the Lower Mainland by replacing the existing practice of individual client-provider text messaging and immediate deletion with a secure, centralized WelTel digital health platform | Read more
  

Disruptive innovations, such as machine learning and predictive analytics, are being increasingly applied within the field of public health for a range of tasks, including detecting outbreaks, identifying patients at higher risk of particular conditions, and resource allocation. The CPS research program is organizing this special seminar series which aims to provide BCCDC trainees, staff and researchers an introduction to the key concepts surrounding machine learning and the types of public health problems it can address, as well as an opportunity to interact with local and regional thought leaders in the area of machine learning.