Theme 4: Treatment DeliveryTheme 4 studies factors that hinder provision of TB therapy and develops solutions to these issues. It conducts observational studies and operational research to define individual or systematic barriers (regulatory, financial, health systems) that impair optimal access to appropriate TB treatment or that impair outcomes from combination therapy. Theme 4 also focuses on developing and evaluating, through interventional studies, policy analyses and cost-effectiveness studies, new approaches to address these barriers. This includes approaches to improve current TB treatment delivery, such as novel models of observed therapy and inducing behavioral changes to enhance adherence to treatment, and strategies to maximise the impact of new tools and drugs when they are introduced into programmatic settings. The theme also focuses of TB treatment delivery, such as novel models of observed therapy and inducing behavioral changes to enhance adherence to treatment. |
Theme 4 Lead: Prof. Nick Paton
National University of Singapore (NUS), Singapore |
ProjectsmTB Genomic Database
Project PI: A/Prof. Teo Yik Ying Project lead: Dr. Rick Ong The project aims to create a comprehensive genomic database of drug-resistant TB strains, which will enable correlation of genotype differences in mTB genome to known phenotypic drug-resistance in South East Asia and help distinguish between neutral phylogenetic polymorphisms from mutations linked with partial or complete drug-resistance. mTB samples are collected in partnership with collaborators in Singapore, Thailand, Vietnam, Malaysia, Indonesia, Myanmar, and Cambodia. Select publications: Bioinformatics tools and databases for whole genome sequence analysis of Mycobacterium tuberculosis. Infect Genet Evol. 2016 Nov;45:359-368. Comparative whole-genome sequence analysis of Mycobacterium tuberculosis isolated from tuberculous meningitis and pulmonary tuberculosis patients. Sci Rep. 2018 Mar 20;8(1):4910. MIST Study
Project lead: Dr. James Molton Current means of optimising TB treatment adherence involves use of Directly Observed Therapy (DOT) which is inconvenient and costly for patients. It also poses logistical problems in remote rural populations. MIST (Mobile Interactive Supervised Therapy) develops a platform for smartphone-based treatment supervision and reminders to patients to enhance TB treatment regimen adherence.The aim of this study are to evaluate the performance, acceptability and efficacy of an electronic system for monitoring and supporting adherence to oral medications. Select publication: Prospective single-arm interventional pilot study to assess a smartphone-based system for measuring and supporting adherence to medication. BMJ Open. 2016 Dec 20;6(12):e014194. |
Theme 4 CollaboratorsLondon School of Hygiene and Tropical Medicine
School of Computing, National University of Singapore, Singapore
University of Southern California, USA
NTP, Myanmar
Yunnan CDC, China
University of Health Sciences, Cambodia
National TB Control Program, Cambodia
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