Dr. Jakob Simmank, the head of the health section of Die Zeit, an online newspaper in Hamburg, Germany, is preparing an article on the fight against tuberculosis (TB), including the use of digital adherence technology (DAT) for TB treatment. Dr. Simmank talked with Evelyn Donor, tuberculosis (TB) nurse at Marilao Rural Health Unit 1 in Bulacan province, Philippines, to better understand the work of the ASCENT project.
(Photo Credit: Angelito Santiago/KNCV)
Reduced access to TB diagnosis and treatment, particularly in this time of the COVID-19 pandemic, has increased the number of TB deaths. WHO reports that in 2020, the global combined deaths among HIV-negative people (1.3 million) and HIV-positive people (214,000) went back to the level of 2017. Moreover, with only a 9.2% fall in deaths between 2015 and 2020, United Nations member states missed the Sustainable Development Goals (SDG) milestone of a 35% reduction (compared with 2015) in TB deaths by 2020.
Leveraging advances in information and communication technology, DAT points to its capability to enhance care and adherence support, potentially leading to improved treatment outcome.
Dr. Jakob Simmank and the Philippines ASCENT team, led by Monalisa Morales, paid a courtesy visit to Marilao Mayor Ricardo Silvestre to talk about the ways DAT can improve TB care.
Initial findings in a cohort of 2,979 patients in Bulacan and Pampanga provinces indicate that adherence rate among drug-sensitive patients was 93% for smart pillbox users and 92% for those using medication sleeve/label. Among drug-resistant TB patients, adherence registered 90% and 79% among users of the smart pillbox and of the SureAdhere video-supported treatment, respectively.
The ongoing ASCENT effectiveness study is collecting data to show whether DAT use and a differentiated response to patient adherence will reduce the number of patients with poor end-of-treatment outcomes compared with patients receiving the standard TB care alone.