Projects

CHALLENGE

Tuberculosis (TB) is an airborne disease that can be spread by coughing or sneezing and is the leading cause of infectious disease worldwide.

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CHALLENGE

Tuberculosis (TB) is an airborne disease that can be spread by coughing or sneezing and is the leading cause of infectious disease worldwide.

The World Health Organization estimates that two billion people – one third of the world’s population—are infected with the bacteria that causes TB. There are an estimated 9 million new cases of TB every year, or approximately 24,000 new cases every day. One-third of daily cases are missed – not diagnosed or not treated or not reported. Among the most vulnerable are women, children, and those with HIV/AIDS TB is a global epidemic.

TB contributes significantly to the cycle of poverty and illness that entraps families and communities. Unfortunately there is also a growing resistance to widely available TB medication. Multi-drug resistant TB (MDR) treatment is almost 2 years long and requires very toxic medication. One person with active, untreated TB can spread the disease to 15 other people in a year, underscoring the dire need for early detection and treatment.

INNOVATION

IHS delivers innovative technology to improve treatment outcomes for TB patients. We provide health information systems that strengthen public-private sector linkages to screen, diagnose, and treat TB patients in both urban and rural communities.

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INNOVATION

IHS delivers innovative technology to improve treatment outcomes for TB patients. We provide health information systems that strengthen public-private sector linkages to screen, diagnose, and treat TB patients in both urban and rural communities, capturing capture data electronically from the first point of health system contact all the way to end of treatment IHS has provided technical assistance for TB technological innovations in 15 countries including Pakistan, Bangladesh, Nepal, Tajikistan, Indonesia, South Africa, Democratic Republic of Congo, Kenya, Uganda, , Malawi, Tanzania, Ethiopia, Zimbabwe, Peru, and Brazil.

We have set up OpenMRS (http://www.openmrs.org) implementations to support MDR-TB programs in Pakistan, Tajikistan, and Nepal. The largest of these implementations has records of more than 30,000 patients suffering from drug-sensitive or drug-resistant TB.

IHS has developed systems using a customized Android phone application backed by OpenMRS to support data collection in the field ranging from patient screening to enrolment, sputum submission, follow-ups, and treatment. These are linked with the XpertSMS and GxAlert systems, which automatically extract results from GeneXpert machines and transmit them to a remote server, allowing automated reporting of results via SMS to patients, caregivers, and TB programs – thereby reducing the time between TB diagnosis and start of treatment.

In an effort to support best practices for TB case detection, IHS created a tablet-based Android application that easily breaks down the process of generating a good quality sputum sample for a patient. The application gauges a patient’s current knowledge of expectorating sputum, plays a video that walks the patient through the process of generating sputum, and then determines whether the video has helped the patient understand the process better, by matching the quality of sputum provided with the patient’s initial knowledge.

Together with global partners, IHS has leveraged process and technology to build several solutions to increase case detection and improve case holding of adult and childhood TB. This includes the use of social enterprise models to engage private providers to enable treatment compliance, and the use of a web-based referral tracking system for TB and HIV to allow close monitoring of patient care and program quality.

IMPACT

Our work addresses all elements of the health system including TB treatment adherence, diagnosis, monitoring, and treatment and disease surveillance. We consistently apply evidence- informed knowledge and technical expertise to complex environments, where TB services are most required.

With the support of our health systems, over 28,000 TB cases and 3700 drug resistant have been identified and enrolled into the treatment program.

We continually aim to reduce the burden of TB across fragile communities. With the deployment of cutting-edge, TB interventionssuch as EMRs and SMS delivery platforms, IHS has seen a reduced loss to treatment initiation and early TB treatment initiation, as well as a stronger communication link between health workers and patients.

Over 28,000 TB cases and 3700 drug resistant have been identified and enrolled into the treatment program.

CHALLENGE

South Africa has the second highest prevalence of TB incidences in the world and the highest rate of drug-resistant TB in Africa. South Africa also faces a high rate of HIV/AIDS among TB incidences (73% of all TB cases identified are HIV positive).

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CHALLENGE

South Africa has the second highest prevalence of TB incidences in the world and the highest rate of drug-resistant TB in Africa. South Africa also faces a high rate of HIV/AIDS among TB incidences (73% of all TB cases identified are HIV positive).

Out of occupational groups, mineworkers in South Africa currently have the highest incidence rate of TB in any working population in the world at 3,000 – 7,000 per 100,000 individuals (10 times the level considered a “TB emergency” by the World Health Organisation). Today there are over 2,000 mines with over 600,000 mineworkers in South Africa who are three times at higher risk for contracting TB compared to the general population.

INNOVATION

IHS is supporting the partnership between Interactive Research Development (IRD) and The Aurum institute in a multi-pronged approach to increase TB and HIV case detection and treatment initiation in selected districts in Ugu and eThekwini districts of the KwaZulu Natal province.

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INNOVATION

IHS is supporting the partnership between Interactive Research Development (IRD) and The Aurum institute in a multi-pronged approach to increase TB and HIV case detection and treatment initiation in selected districts in Ugu and eThekwini districts of the KwaZulu Natal province.

An innovative mHealth application is being designed to strengthen health systems through facility-based screening and increase access to care though community-based screening. The android-based tool will streamline data collection, enhance reporting in high-volume health facilities and improve access to hard-to-reach rural populations.

The MINE TB initiative combines several best practices including performance-based incentivization and m-health screening to ensure an end-to-end health system.

Through the innovative technology, the program aims to boost active case detection and notification, and build implementation methods to improve treatment outcomes – and eventually reduce the incidences of infectious TB in vulnerable communities of South Africa.

IMPACT

Since the beginning of 2015, 89,586 individuals have been screened through the mobile application from the Ugu and Ethekwani districts, and out of these, 1551 patients have been found MTB positive and referred for treatment.

The project is being funded by the TB REACH Secretariat, which is a WHO Stop TB Partnership initiative dedicated to promoting early and increased TB case-detection using innovative approaches among poor, underserved, and vulnerable populations.

89,586 individuals have been screened through the mobile application from the Ugu & Ethekwani districts

CHALLENGE

For the first time in over 50 years, two new anti-TB drugs (bedaquiline and delamanid) have been approved and introduced - offering new hope for treatment to countless patients around the world suffering from Multidrug-resistant tuberculosis (MDR-TB) and Extensively drug-resistant TB (XDR-TB).

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CHALLENGE

For the first time in over 50 years, two new anti-TB drugs (bedaquiline and delamanid) have been approved and introduced – offering new hope for treatment to countless patients around the world suffering from Multidrug-resistant tuberculosis (MDR-TB) and Extensively drug-resistant TB (XDR-TB). However efforts to deliver these effective drugs to patients in low and middle income countries are being hampered by inaccessibility.
IHS’ electronic data collection and management system is creating the infrastructure for widened reach and appropriate delivery of these drugs by supporting the endTB project – a multi-country collaboration between Médecins Sans Frontières (MSF), Partners in Health (PIH), and Interactive Research and Development (IRD).

 

INNOVATION

Working together with, Thoughtworks, IHS is developing and adapting Bahmni Electronic Medical Record (EMR) to radically reshape the management work flow of Tuberculosis merging health systems to provide a comprehensive platform for close monitoring, treatment delivery, and evaluation.

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INNOVATION

Working together with, Thoughtworks, IHS is developing and adapting Bahmni Electronic Medical Record (EMR) to radically reshape the management work flow of Tuberculosis merging health systems to provide a comprehensive platform for close monitoring, treatment delivery, and evaluation. The integrated open source platform will employ an android-based technology for capturing real-time data and monitoring of patient care and program quality. The system will be deployed across 16 countries and IHS is responsible for the implementation in 3 countries – Pakistan, Bangladesh and Indonesia.

The impact of this innovation will pave the way for standardized clinical data across borders and eliminate the inefficiencies that have plagued traditional health systems for decades. IHS hopes to improve the efficacy of safety data and end the unregulated market of private health providers by developing an efficient information system of care in low-resource settings.

2600 patients in 16 countries on MDR-TB treatment with new drugs will be monitored closely through the innovative mobile platform for response to treatment regimen and for potential adverse events.

The international project is funded by UNITAID with a grant of $60.4m. The project aims to find shorter, less toxic and more effective treatments for drug-resistant TB, through access to new drugs, clinical trials, and advocacy at country and global level.

The Brand Crew