Project lead: Prof Andrew Hayward, The Farr Institute
A team of researchers from The Farr Institute in London, in partnership with the NHS, are testing a mobile app that could help patients with managing their tuberculosis treatment.
Tuberculosis (TB) is an infectious disease that is spread in tiny droplets in our breath mainly during coughing. Even though effective treatments to kill TB bacteria are available, in 2014, 9.6 million people became infected with TB and 1.5 million people died from TB-related causes worldwide.
A 6-month course of medication to treat TB disease can be prescribed but it can be very difficult to support people to continue to take their medication over this period of time. If patients repeatedly miss their treatment doses, the TB bacteria can become resistant to the medication. Drug-resistant TB is harder to treat because the medicines used to treat it are less effective, need to be taken for longer, may need to be given as injections and have more side effects. Failure to take regular treatment can also lead to spread of infection to other people.
Given these treatment challenges, the World Health Organisation recommends Directly Observed Therapy (DOT) to manage the treatment of TB. This involves a healthcare worker or another responsible adult observing a patient, in person taking their TB medication. In the UK, DOT is recommended for people who may have complicated social problems and may find it difficult to stay on their treatment, such as those with a history of being homeless or unstable home environments, drug use and imprisonment. It is also recommended for people with drug resistant disease.
There is a lot of mixed evidence on whether DOT improves cure rates or reduces the risk of TB re-lapsing. Having to travel to a clinic each day is expensive and to be observed taking their treatment can sometimes make patients feel like they are being treated unfairly. It is also difficult and expensive for clinics to deliver DOT.