Aims:

To improve tuberculosis (TB) case finding and prevention – both critically important in reducing the spread of TB, achieving End TB targets and improving quality of life.

Objectives:

To develop a tool that supports better (real-time and accurate) communication between those involved in TB contact tracing in Sabah, namely nurses and doctors in the TB clinics, health inspectors working out in the community to undertake household contact tracing and the Sabah State Health Department, which oversees the TB program.

Summary:

TB contact investigation is a critical strategy for working towards the milestones of the World Health Organization’s End TB Strategy. This is a cost-effective way to find other cases of active TB and deliver preventive therapy to those most at risk of being infected and getting sick with TB (children under five years of age and people who are immunosuppressed). Since 2017, we have been implementing a health system strengthening study at three clinics in Kota Kinabalu, Malaysia, to improve contact investigation and management. In this setting, many people live in poverty, the primary care system is poorly resourced and TB rates are high. Our research has found that public health mechanisms are available for TB contact investigation, but only 56% of identified contacts had TB screening initiated. A priority need is a tool to support prompt and accurate communication between staff coordinating TB contact investigation, namely, health inspectors, healthcare staff and Sabah State Health Department.

Key features of the application:

a. Real time up-to-date communication between health care staff in the clinic and health inspectors in the community

b. Alerts for follow-up

c. Access to data without network connection

d. Secure and user-friendly data collection

e. Dashboard with interactive charts for managers to monitor latest real-time data collection

This is pragmatic operational research, which will be conducted over 18 months at the three outpatient clinics that see the majority of TB cases in Kota Kinabalu. We will implement activities and measure impact on the TB contact cascade of care.

Chief Investigator:
  • Dr Michelle Goroh
Investigators
Project manager:
Contact information:
Project dates:

January 2020 - June 2021

Funders:

  • HOTNORTH 

                   

Collaborators:
  • Menzies School of Health Research – research implementation 

                   

  • IDSKKS (Infectious Disease Society of Kota Kinabalu Sabah) – research implementation

                   

  • UMS - University Malaysia Sabah – research implementation

                   

  • Sabah State Health Department – endorsement, implementation  

                   

  • Dure technology – application developer

                   

  1. Goroh, M.M.D., van den Boogaard, C.H., Ibrahim, M.Y., Tha, N.O., Swe; Robinson, F., Lukman, K.A., Jeffree, M.S., William, T. & Ralph, A.P. (2020). Factors Affecting Continued Participation in Tuberculosis Contact Investigation in a Low-Income, High-Burden Setting. Trop. Med. Infect. Dis. 5, 124.
  2. Goroh, M., Rajahram, G. S., Avoi, R., Van Den Boogaard, C., William, T., Ralph, A. P. & Lowbridge, C. (2020). Epidemiology of tuberculosis in Sabah, Malaysia, 2012-2018. Infectious diseases of poverty, 9(1), 119. https://doi.org/10.1186/s40249-020-00739-7 
  3. Lowbridge, C. & Ralph, A.P. Tuberculosis: yesterday, today and tomorrow. (2020). Microbiology Australia, 41(4), 192-195. https://doi.org/10.1071/MA20052