HOME
Actiphage®-supported Clinical Tools for Knowledge-driven Innovations in Diagnostic Solutions for TB in young children
ACT4KIDS-TB is an EDCTP3-funded project (Global Health, Horizon Europe) that aims to close the diagnostic gap in paediatric tuberculosis by developing and validating a package of three linked innovations: Actiphage®, a rapid blood-based test for detecting active Mycobacterium tuberculosis infection; a paediatric Clinical Decision-Making app (CDM-app) that guides health care workers through diagnosis at the child's bedside; and computer-aided detection (CAD) for chest X-ray reading, brought closer to the point of care and validated for children for the first time.
Running for four years (2026–2030), the project is coordinated by the Institute of Tropical Medicine (ITM) in Antwerp, Belgium, together with partners in South Africa, Benin, and Kenya, and will generate the clinical, economic, and implementation evidence needed to bring better TB diagnostics to children where they are needed most.
About
The Challenge
Each year, an estimated 1.25 million children develop tuberculosis, yet more than half are never diagnosed or reported. Diagnosing TB in young children is especially difficult: the disease is paucibacillary (few bacteria are present in samples), symptoms and chest X-ray findings differ from those in adults, and collecting good-quality samples from young children is challenging. As a result, 96% of children who die of TB were never treated. ACT4KIDS-TB was designed to address this gap directly, by testing three complementary diagnostic innovations together, in the settings where the need is greatest.
Actiphage
Actiphage was originally developed to detect Mycobacterium bovis infection in cattle. ACT4KIDS-TB adapts this "One Health" veterinary technology for use in children with presumptive TB. The test uses a mycobacteria-specific bacteriophage that infects and lyses live M. tuberculosis cells, combined with PCR to confirm species identity. Because it targets only viable bacteria, Actiphage® also provides direct evidence that infection is active — something existing rapid tests cannot do. It works on a small venous blood sample, does not require a cold chain, and delivers a result within hours rather than the four to six weeks needed for mycobacterial culture, while only requiring BSL-2 (rather than BSL-3) laboratory conditions. ACT4KIDS-TB will build on earlier adult and pilot paediatric work to validate Actiphage® in children in Benin and South Africa, and to explore how the test can be brought even closer to the point of care.
CDM-app
The paediatric Clinical Decision-Making app (CDM-app) is an open-access digital tool that supports health care workers, from community-level staff to experienced clinicians, through the diagnostic process for presumptive paediatric TB. Co-designed with end-users, the app combines symptoms, clinical and demographic characteristics, chest X-ray findings, and results from Actiphage® and standard bacteriological tests into a Bayesian prediction rule, giving real-time, visual treatment-decision guidance. It is designed to be modular and adaptable, so that it can be extended to other high-burden, resource-limited settings beyond the project.
CAD for chest X-ray
Computer-aided detection (CAD) software for chest X-ray interpretation is already an established tool in adult TB diagnosis, but has not yet been externally validated in children. ACT4KIDS-TB will build a secure, online chest X-ray repository from children enrolled in the trial in Benin and South Africa, interpreted by expert human readers, to validate existing CAD algorithms for paediatric use. The project will also work with CAD developers to bring this technology closer to the point of care through a CAD-app, and to integrate it with the CDM-app, so that all three innovations work together as a single diagnostic package.
A consortium spanning Europe and sub-Saharan Africa
ACT4KIDS-TB is coordinated by the Institute of Tropical Medicine (ITM), Antwerp, Belgium, and brings together:
- Desmond Tutu TB Centre, Stellenbosch University (DTTC/SU), South Africa — scientific coordination
- Centre National Hospitalier de PneumoPhtisiologie (CNHPP), Benin
- KEMRI Wellcome Trust Research Programme (KWTRP), Nairobi, Kenya
- Aga Khan University (AKU), Kenya
- University of Cape Town (UCT), South Africa
Together, this consortium combines clinical trial capacity in Benin and South Africa, digital health and CDM expertise from Kenya, and health economics and social science expertise, with the shared aim of generating evidence that is directly usable by national TB programmes and international guideline bodies.
Work Packages
Gallery
Contact Us
Get in Touch
We’d love to hear from you! Whether you have a question, need assistance, or just want to say hello our team is here to help.