National anti-tuberculosis efforts are increasingly involving digital technologies, such as mobile applications to support treatment adherence and electronic surveillance systems that enable real-time monitoring of a country’s TB situation.
These are just some of the emerging examples of how digital technology can be used to advance progress towards the global End TB Strategy. Digital technologies can also play a critical role amidst the current COVID-19 pandemic. People ill with COVID-19 and TB show similar symptoms such as cough, fever and difficulty breathing, as both diseases primarily attack the lungs. It is anticipated that people ill with both TB and COVID-19 may have poorer treatment outcomes, especially if TB treatment is interrupted, according to a WHO Information Note on TB and COVID-19.
“We are seeing more and more examples of technological innovation within TB programmes, encouraged by expanding access to technology and the Internet in low- and middle-income settings, and the increasing interest from health care providers to innovate in the face of TB challenges,” said Dr Tereza Kasaeva, Director of WHO’s Global TB Programme.
However, at country level, the proliferation of such technologies and innovations can be difficult to navigate. While digital and mobile apps to help control TB are welcome innovations, countries need evidence to identify which ones are effective and worth adopting to scale up nationally.
Realising the potential role of digital technologies in different aspects of TB care requires an understanding of the complex environments in which they will be put to use. Implementation research (IR) is uniquely placed as an approach to systematically explore these challenges and generate new evidence to guide the optimal use and scale-up of digital technology across the TB continuum of care.
TDR has a long history of promoting and supporting IR, as well as conducting a range of activities designed to contribute to the end of TB. This year, TDR is leveraging experience in both arenas to develop a toolkit to help national TB programmes and key TB partners conceptualize, budget and prepare for an IR study focused on the optimization of digital interventions within TB programmes.
The IR toolkit to inform the implementation and scale-up of digital technologies for TB, known as IR4DTB, is being developed in partnership with WHO’s Global TB Programme. IR4DTB aims to generate new evidence to bridge the knowledge gaps on an optimal application of digital health technologies specific to TB work and inform future WHO guidance on their use. This tool is an adaptation of the IR Toolkit developed by TDR in 2014 and contains six modules designed to guide users through the key IR steps, resulting in the development of a comprehensive IR proposal. The modules have been designed to reflect key steps in the IR process, namely:
IR4DBT draws upon real-life case studies of digital technologies being trialled and scaled up within various TB settings. The toolkit will be piloted in select locations to gather feedback from users. The finalized version will be released later this year and made freely available on TDR’s website.
For more information, please contact Dr Corinne Merle.