Tuberculosis

Forms of tuberculosis which have evolved to survive and resist antibiotic drugs (rifampicin and isoniazid) are referred to as multi-drug resistant TB (MDR-TB).

MDR-TB is a global public health emergency and the leading cause of death from antimicrobial resistance globally.

Directly-observed therapy is the standard therapy offered for tuberculosis. It requires a healthcare worker to watch the patient swallow each dose of their medication. This therapy is not very cost-efficient and cures only 57% of people with MDR-TB globally.

Video-observed therapy uses a smartphone (or other video-compatible equipment) to observe patients taking their medications remotely. This could help to ensure that people with TB who are not able to easily get to hospital settings complete their treatment successfully.

Innovative, person-centred strategies like the use of video-observed therapy are urgently needed but have limited implementation evidence to date, especially from low-income countries.

Dr Khosa and Dr Wingfield from Instituto Nacional de Saúde and the Liverpool School of Tropical Medicine will assess the feasibility and acceptability of video-observed therapy for people with MDR-TB in Mozambique, while building capacity, consolidating collaborations, and training the next generation of researchers.

Mozambique is a low-income country with the triple burden of TB, MDR-TB, and TB in adults with HIV. With the rapid national increase in smartphone use in Mozambique, video-observed therapy could be a key intervention to support people with MDR-TB.

This project has been funded by the 2022 Dorothy Temple Cross International Collaboration Grant.