CITY OF MALOLOS – In a video conference yesterday, Bulacan Governor Daniel R. Fernando and health workers manning selected health facilities in the province held a randomization activity that assigned the facilities to groups to evaluate the effectiveness of digital adherence technology (DAT) for the treatment of tuberculosis (TB).
Through the Unitaid-funded Adherence Support Coalition to End TB (ASCENT) project, KNCV Tuberculosis Foundation is engaging the national TB control program and key stakeholders in five countries Ethiopia, South Africa, Tanzania, Ukraine, and The Philippines to facilitate country adoption and uptake of digital adherence technologies, generate critical evidence for optimal use and scale-up, create a global market and plan for implementing DATs, and engage key global and in-country stakeholders to prepare for scale-up of the DAT intervention. ASCENT is expected to provide evidence that the use of DAT improves treatment adherence leading to better health outcomes.
The randomization event identified 16 health facilities that will use DATs and the standard of care or SOC for TB (intervention group) and 16 facilities that will apply only the standard of care (control group). The two groups will be assessed to determine whether the use of DAT with SOC reduced the number of adult drug-sensitive patients with poor end-of-treatment outcomes compared with patients who were treated using only standard of care.
Dr. Jason Alacapa, the project’s Research Coordinator, added “The 16 facilities in the intervention group – all catering to drug-sensitive TB patients will be randomly assigned either to the 99DOTS medication sleeve or to the evriMED/smart pill box”
All six Programmatic Management of Drug-Resistant TB (PMDT) facilities in the province will adopt video-supported treatment (VST) and evriMed/smart pill box technologies. Sub-studies will assess among patients and healthcare workers the acceptability and feasibility of using these DATs.
Governor Daniel Fernando, in his keynote speech, said that while the world has been fighting TB for more than a hundred years, the disease remains the leading infectious disease cause of mortality more than COVID-19, and yet the TB program is the most underfunded.
“I admit that as we divert finances for COVID, care for patients with TB is compromised. Since the national lockdown, there has been a 59% drop in daily GeneXpert testing and 23% reduction in new TB diagnosis. But we must remember to never let this pandemic take our focus away from other health problems” Fernando said.
The governor thanked KNCV-ASCENT and other health partners for highlighting the role of governance in the fight against TB. Health governance in tandem with the use of digital adherence technology will strengthen and ensure adherence to TB treatment remotely. The importance of DAT is underscored further now that the world is preparing for a possible new normal situation where face-to-face interaction is limited.
Dr. Andre Daniel E. Villanueva, ASCENT Project Manager and KNCV Country Representative presented an overview of the project while Dr. Jocelyn Gomez, the NTP Medical Coordinator of Bulacan read the groupings after the random selection of the health facilities.
Kristian van Kalmthout, ASCENT Project Director from KNCV Headquarters in The Netherlands, said that in the coming two years they will find ways to make DAT more accessible to ensure TB patients’ adherence in taking complete and proper medication.
Rachel Powers, ASCENT Philippines technical focal point, also from KNCV Headquarters, shared the next steps after the randomization activity that includes training and preparation of materials up to the implementation proper.
KNCV is implementing ASCENT together with The Aurum Institute, London School of Hygiene and Tropical Medicine, and PATH.###