Digital Therapeutics (DTx) for Multi-Drug Resistant Tuberculosis (MDR-TB)
Aim
Multi-drug resistant tuberculosis (MDR-TB) is a growing health problem in many countries and a major contributor to antibiotic resistance worldwide, according to the WHO’s Global TB Report 2021. Mumbai, India’s most populous city, is a hot spot for TB and MDR-TB, especially the city’s crowded slums. In Mumbai and across the country, people who get infected with TB often have to wait for months before they are properly diagnosed, which helps spur the increase of drug-resistant tuberculosis (DR-TB) and MDR-TB cases in this context. MDR-TB treatment typically spans over 24-months during which patients are prescribed a course of second-line drugs which may cause patients to experience adverse side effects. The challenging and protracted nature of MDR-TB treatment contributes to poorer treatment outcomes and a success rate of approximately 54 per cent. Together with patients and partners we believe there is an opportunity to explore digital tools to help address this health demand.
Driven by this demand and building on the lessons of the Video Observed TB Treatment (VOT) project, the MSF Sweden Innovation Unit (SIU) and partners at MSF India and MSF Operational Center Brussels (OCB) launched the Digital Therapeutic (DTx) for MDR-TB project DOST (meaning “friend” in Hindi) project in 2019.
The DOST project team aims to support a new patient-centred model of care for improved treatment literacy, medication adherence and care continuity using a smartphone application purposefully designed for MDR-TB patients in the Mumbai context. A key rationale of the DOST platform is to strengthen existing clinic-based patient support activities, decentralize patient management and ultimately contribute to a positive impact on treatment adherence and psychological well-being.
From November 2021 to January 2022 the DOST patient support platform was provided to an initial cohort of 28 MDR-TB patients in Mumbai as a part of the initial feasibility assessment. This assessment is now being used to inform the upcoming iteration of the technical and operational elements of DOST enabling subsequent delivery to a further patient cohort focusing largely on enabling patients in the initiation phase of their treatment for MDR-TB.
Status
INITIATION
Completed.
DEVELOPMENT
Completed.
IMPLEMENTATION
Ongoing.
Stakeholders
MSF India (DWBI)
MSF Sweden Innovation Unit (SIU)
South African Medical Unit (SAMU)
MSF Operational Center Brussels (OCB)
Funding
MSF Sweden Innovation Unit
Transformational Investment Capacity (TIC)
Contact
Hanna Phelan, Project Lead, Digital Therapeutics (DTx) for TB and Diabetes
hanna.phelan@stockholm.msf.org