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CTRI Number  CTRI/2025/08/092157 [Registered on: 01/08/2025] Trial Registered Prospectively
Last Modified On: 31/07/2025
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Diagnostic 
Study Design  Other 
Public Title of Study   Diagnostics Development for TB screening and management  
Scientific Title of Study   Rapid Research in Diagnostics Development for TB Network (R2D2 TB Network) Study 
Trial Acronym  R2D2 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Balamugesh Thangakunam 
Designation  Professor 
Affiliation  Christian Medical College Vellore 
Address  Department of Pulmonary Medicine (Ranipet Campus)
Kilminnal Village
Vellore
TAMIL NADU
632517
India 
Phone  7907384912  
Fax    
Email  drbalamugesh@cmcvellore.ac.in  
 
Details of Contact Person
Scientific Query
 
Name  Balamugesh Thangakunam 
Designation  Professor 
Affiliation  Christian Medical College Vellore 
Address  Department of Pulmonary Medicine (Ranipet Campus)
Kilminnal Village
Vellore
TAMIL NADU
632517
India 
Phone  7907384912  
Fax    
Email  drbalamugesh@cmcvellore.ac.in  
 
Details of Contact Person
Public Query
 
Name  Balamugesh Thangakunam 
Designation  Professor 
Affiliation  Christian Medical College Vellore 
Address  Department of Pulmonary Medicine (Ranipet Campus)
Kilminnal Village
Vellore
TAMIL NADU
632517
India 
Phone  7907384912  
Fax    
Email  drbalamugesh@cmcvellore.ac.in  
 
Source of Monetary or Material Support  
National Institutes of Health (NIH) 9000 Rockville Pike Bethesda, Maryland 20892 301-496-4000 TTY 301-402-9612 
 
Primary Sponsor  
Name  National Institutes of Health 
Address  National Institutes of Health (NIH) 9000 Rockville Pike Bethesda, Maryland 20892 301-496-4000 TTY 301-402-9612  
Type of Sponsor  Government funding agency 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     Viet Nam
Philippines
South Africa
Uganda
India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Balamugesh Thangakunam  Christian Medical College  Department of Pulmonary Medicine (Ranipet Campus) Kilminnal Village
Vellore
TAMIL NADU 
7904384912

drbalamugesh@cmcvellore.ac.in 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
Institutional Review Board, Office of Research  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: J984||Other disorders of lung,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Novel TB screening and diagnostic tests   Novel diagnostics like CAD-computer-aided diagnosis CRP-C-reactive protein FIND-Foundation for Innovative New Diagnostics LAM -lipoarabinomannan TAM-T-cell Activation Marker These tests will be performed only at baseline(0 weeks)  
Intervention  Routine Standard of care TB screening and diagnostic tests  Current diagnostic Gold standard tests like GeneXpert, MGIT culture and Drug sensitivity testing. These tests will be performed at baseline(0 weeks) and at 2months to 7months time point. 
 
Inclusion Criteria  
Age From  12.00 Year(s)
Age To  90.00 Year(s)
Gender  Both 
Details  We will include adults and adolescents who are positive for TB and RIF resistance according to routine diagnostic testing (based typically on Xpert MTB/RIF, Xpert MTB/RIF Ultra, or Hain MTBDRplus).  
 
ExclusionCriteria 
Details  We will exclude people whohave negative or contaminated results on all baseline (i.e., enrollment) sputum cultures, are unable to provide at least two sputum specimens of 3 mL each or a high-quality specimen with a volume of at least 6 are unable or unwilling to provide informed consent

 
 
Method of Generating Random Sequence   Not Applicable 
Method of Concealment   Not Applicable 
Blinding/Masking   Not Applicable 
Primary Outcome  
Outcome  TimePoints 
This is expected to improve the participants overall TB care and diagnostics.   Cross-sectional study, at TB screening level, which will be the baseline (0 weeks) and Follow-up (2 to 7 monhts)  
 
Secondary Outcome  
Outcome  TimePoints 
To evaluate new tests to diagnose TB more easily & rapidly & rapid diagnosis.   TB screening level (0 weeks), which will be the baseline visit & at follow-up visit (2 to 7 months) 
 
Target Sample Size   Total Sample Size="8200"
Sample Size from India="2250" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 2 
Date of First Enrollment (India)   17/08/2026 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  18/08/2025 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="5"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)   Not Yet Recruiting 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary  

The Rapid Research in Diagnostics Development for TB Network (R2D2 TB Network) study seeks to identify and rigorously assess promising early stage tuberculosis (TB) triage and diagnostic tests (hereafter referred to as “novel diagnostics”) in clinical studies conducted in settings of intended use. Rapid diagnosis and effective treatment are critical for improving patient outcomes and reducing TB transmission. However, analysis of care cascades and prevalence surveys indicate that 40-60% of patients with TB are not initiated on effective treatment.1, 2 The different types of tests required to reduce this “diagnostic gap” have been described in the form of target product profiles (TPPs). The highest- priority TPPs are for: 1) a point-of-care, non-sputum biomarker-based test to facilitate rapid TB diagnosis using easily accessible samples (a biomarker test) and 2) a simple, low-cost test that can be used by front-line health workers to rule-out TB (a triage test). The R2D2 TB Network study is a phased evaluation of promising novel TB diagnostics, with iterative assessment of early/late prototypes nested within large-scale validation of design-locked products. In all phases, the accuracy of novel diagnostics will be compared against a reference standard including sputum/urine Gene Xpert® MTB/RIF Ultra and sputum mycobacterial culture, which are standard of care for tests used routinely in patient care.

 
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