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TB REACH provides grants to partners for testing innovative approaches and technologies aimed at increasing the number of people diagnosed and treated for TB, decreasing the time to appropriate treatment and improving treatment success rates.
Interventions
Millions of people around the world become ill with tuberculosis (TB) each year. 30% of them are missed by the current systems. Most of the deaths caused by TB are among people who are missed. TB REACH supports partners across the globe to test new tools and approaches to reach the unreached.
You can search for projects by the different types of interventions used to improve TB case detection, notification and treatment outcomes.
Artificial Intelligence
Projects that have employed software to automatically interpret, images or sounds. Most of the software applications have been focused on x-ray images but other applications include cough monitors and reading microscopy slides and using AI to identify geographic hotspots for screening.
Chest X-ray
Often used decades ago as a tool for mass screening in lower burden settings, CXR has been increasingly used by implementers to screen people for TB as it has very high sensitivity, and new digital equipment has lowered running costs and is often paired with AI software.
Community-based Active Case Finding
Projects often use outreach efforts of different types: mobile vans, outreach workers, chest camps etc., to bring TB services into communities to reduce the travel times and costs for key populations.
Contact Investigation
A well tested approach to identifying people with TB; our projects have used multiple types of approaches, algorithms and methods to screen contacts of people with TB. Contact investigation is the often first step for enrolling people on preventive treatment and critical for pediatric TB interventions.
Providing Treatment Support
There is a growing interest in providing support for people with TB that doesn’t involve the traditional DOT model. Numerous technologies exist to help health workers and people on anti-TB treatment to take all of their medications. In addition, the importance of supportive services and human communication are critical to provide quality care.
Empowering Women & Girls
While it is widely understood that males bear a higher burden of TB, it is also well documented that TB is a disease of poverty, and women and girls are more affected by poverty, and empowering them can help the overall health system improve outcomes for everyone. A number of projects have specifically included the empowerment of women and girls as part of their activities.
Facility Based Screening
While the standard approach to TB case finding is through symptom screening, several studies have shown that many people with symptoms visiting health centers are missed. Ensuring proper screening at health facilities can be an inexpensive way to reach people who may be currently missed.
Key Populations
Key populations include people who are vulnerable, marginalized, underserved or at-risk of TB infection and illness. These will vary by country and region but often includes prisoners, mobile populations, miners, people who use drugs, and others.
Lab Strengthening/Diagnostics
This can include the introduction of new diagnostic tools (Xpert, LAM, LAMP, Truenat and others), it may include novel approaches to diagnostics such as frontloading sputum collection or pooling samples, and it also includes projects that worked to improve the laboratory system through transport networks, lab system strengthening and/or reporting systems.
Demand Generation and Community Mobilization
Some interventions focus on messaging, whether through mass media, SMS services or other channels, to promote health seeking behaviour – whether pubic or private and improve the uptake of TB screening and diagnostic services.
Pediatric TB
While we currently miss about 30% of all people who develop TB, we miss a greater proportion of children with TB, often due to difficulties making a diagnosis in kids. There are many different types of interventions that have been done to try to improve this deficit.
Private Provider Engagement
In many settings, people who are ill will first visit a private provider for care. In some places many people will receive treatment for TB in the private sector. Developing links with the myriad of different provider types including informal providers, is an important part of the TB response, and many different models of engagement have been developed over the last 10 years.
Product Innovation/mHealth
As part of some grants, a new product/innovation was developed or tested. This might be a software, test, mobile application or other tool. mHealth interventions include the use of mobile and wireless technologies to support the achievement of health objectives and TB REACH grantees have often introduced these technologies in their settings.
TB Preventative Treatment
Treating all people with TB means greatly scaling up treatment of infection. TB REACH grants have been used to begin to scale the use of preventative treatment for TB among different populations. This is part of the UNHLM targets and while there is a large case detection gap, the gap for putting people on preventative treatment is even greater.
Use of New Drug Regimens
In several TB REACH projects, our grantees have introduced the use of novel treatment regimens, either for TB infection, or drug resistant TB. While TB REACH does not fund clinical trials, these service-delivery projects can help produce evidence about the challenges and benefits of using new drugs under programmatic conditions.