New innovative way to tackle TB
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.