New in­no­va­tive way to tackle TB

Cape Times - - FRONT PAGE - Staff Writer

THE Des­mond Tutu TB Cen­tre (DTTC) at Stel­len­bosch Univer­sity’s (SU) Fac­ulty of Medicine and Health Sci­ences (FMHS) has re­cently re­ceived a R19 mil­lion grant for a project to re­duce the ini­tial loss of fol­low-up of TB pa­tients in South Africa.

The fund­ing was from the Bill and Melinda Gates Foun­da­tion.

Named the LinkedIn study, the re­search project will be jointly led by Pro­fes­sor An­neke Hes­sel­ing, the direc­tor of the DTTC, and Doc­tor Muham­mad Os­man, from the DTTC.

Doc­tor Sue-Ann Mee­han, who re­cently com­pleted her PhD at the DTTC, is a key mem­ber of the team .

Os­man said South Africa had the high­est TB in­ci­dence in the world in 2016 (781 per 100 000 pop­u­la­tion), that TB was the coun­try’s lead­ing cause of death, and that the re­search project ini­tia­tive aimed to ad­dress some of the chal­lenges of TB.

She said that re­gard­ing the ini­tial loss to fol­low up ( ILTFU) for TB pa­tients, Os­man re­ferred to pa­tients who had al­ready ac­cessed health ser­vices and had been di­ag­nosed with TB, but due to many rea­sons were not no­ti­fied of the TB pro­gramme and were usu­ally not on TB treat­ment.

“ILTFU TB pa­tients are not counted as TB cases in the na­tional TB pro­gramme since they do not ap­pear on TB treat­ment reg­is­ters (the cur­rent sur­veil­lance tool to count the num­ber and type of TB cases in South Africa). This is a se­ri­ous con­cern, both to in­di­vid­ual pa­tients as well as to the health sys­tem.

“For pa­tients, hav­ing a known di­ag­no­sis of TB and not be­ing ap­pro­pri­ately treated can have se­ri­ous con­se­quences, in­clud­ing death.

“For health sys­tems, this re­sults in the un­der-reporting of the TB bur­den in South Africa, and on­go­ing TB trans­mis­sion in com­mu­ni­ties.

“We will at­tempt to en­sure all pa­tients di­ag­nosed with TB are au­to­mat­i­cally no­ti­fied and ap­pear in TB reg­is­ters, and there­after at­tempt to link the pa­tients with care at the ap­pro­pri­ate fa­cil­ity.”

The LinkedIn study is also in line with the South African Na­tional Depart­ment of Health’s pri­or­ity to find miss­ing TB pa­tients.

“This is one of three funded stud­ies that grew out of dis­cus­sions with the newly formed South African TB Demon­stra­tion, Scale and Sus­tain­abil­ity con­sor­tium, funded by the Bill and Melinda Gates Foun­da­tion, the South African Med­i­cal Re­search Coun­cil, and TB Reach,” said Mee­han.

“At the most ba­sic level, it will be able to trig­ger one-way SMS re­minders to a pa­tient about TB re­sults, ap­point­ments at the fa­cil­ity, and their in­di­vid­ual need for fol­low-up.

“We will add more com­plex­ity that will al­low twoway SMSes where pa­tients can re­spond and en­gage with the sys­tem. In the Western Cape we will also try to in­te­grate the no­ti­fi­ca­tion sys­tem with a so­cial me­dia ap­pli­ca­tion, such as What­sApp,” said Mee­han.

LinkedIn will be im­ple­mented in the Western Cape, KwaZulu-Na­tal and Gaut­eng prov­inces, and the fi­nal re­sults are ex­pected to be avail­able in early 2020.


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