Theme 4: Treatment Delivery
Theme 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.
mTB 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.
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.
Health Policy and Systems Research in Myanmar
Project leads: Prof. Richard Coker & A/Prof. Mishal Khan
One of first international research groups to conduct a series of multidisciplinary studies investigating how health system functioning and policy setting - in a low resource setting facing unprecedented influxes of donor aid - impact TB control and generation of drug resistance.
Epidemiological & Microeconomic studies in Yunnan, China
Epidemiology Project lead: A/Prof Mishal Khan
Economic Project lead: A/Prof Joanne Yoong
The project focuses on identifying factors associated with prolonged delay to accessing TB care and on assessing the cost and cost-effectiveness of methods to increase the number of people diagnosed and initiated on TB treatment in Yunnan province, China.
Research to Inform Optimal Resource Allocation for TB Control in Cambodia
Project PI: A/Prof. Mishal Khan
Project Co-PIs: A/Prof. Alex Cook, A/Prof. Joanne Yoong, A/Prof. Teo Yik Ying, Dr. Neisha Sundaram
The overarching aim of this 5-year project is to identify key TB control challenges (working closely with the National TB Programme), and to design and conduct policy relevant research. Studies include a qualitative investigation of barriers to accessing TB care, a cost-effectiveness comparison of active case finding interventions, pilot testing of incentives to influence patient and health provider behaviour and mTB genomic analyses.
Theme 4 Collaborators
London School of Hygiene and Tropical Medicine
School of Computing, National University of Singapore, Singapore
University of Southern California, USA
Yunnan CDC, China
University of Health Sciences, Cambodia
National TB Control Program, Cambodia