This MSF-sponsored trial in Uzbekistan, Belarus and South Africa is comparing three novel, exclusively oral, six-month regimens for the treatment of pulmonary MDR-TB with the current standard of care, which currently entails between nine and 24 months of treatment, including four–six months of injections.
E-registry for MDR-exposed contacts
The diagnosis of MDR-TB is the start of a journey not only for the patient but also for their exposed household contacts. An electronic tool has been developed for registration and data collation to facilitate contact tracing and surveillance, and simultaneously build a multi-national observational cohort and generate a line-list of contacts potentially eligible for PT. Peru, Mongolia, Bhutan and Somaliland will be the first early adopter countries, with further iterative development and process evaluation.
Umoya Omuhle ("good air")
Infection prevention and control for drug-resistant tuberculosis in South Africa in the era of decentralised care: a whole systems approach
The transmission of drug-resistant TB (DR-TB) in health centres in South Africa is well documented, but it is not clear how much clinic transmission contributes overall. Working in Western Cape and KwaZulu-Natal provinces this project will estimate the contribution of transmission in health care facilities to overall DR-TB transmission; and explore organisational, structural and social factors contributing to transmission. These data will inform development of an intervention package. We will estimate the impact this intervention package could have on DR-TB incidence in South Africa, and the economic benefits for both patients and the South African health system.
Optimising health systems to improve delivery of decentralised care for patients with drug-resistant tuberculosis
This project in Western Cape, Eastern Cape and KwaZuluNatal seeks to evaluate implementation of decentralised care for drug-resistant TB in South Africa, and identify interventions to optimise this approach. It explores policy and health systems processes involved in decentralisation of TB treatment, and will identify related features associated with positive outcomes for patients, health systems constraints and enablers.
TB Centre members: Alison Grant
Combating drug resistant TB in Myanmar and Yunnan Province, China
In collaboration with the National TB Control programmes of Myanmar and China we conducted: a situational assessment of TB control and the health system in Yunnan and Myanmar; an epidemiological investigation of patient and health-system level risk factors for the development of drug-resistant TB in Myanmar; and a qualitative investigation of financial barriers in accessing care of drug-resistant TB in Yunnan.