Halting the dual Tuberculosis & Diabetes Epidemic
Emergence of dual tuberculosis (TB)/diabetes mellitus (DM) epidemic threatens health and progress in sub-Saharan Africa. Interventions for these and other epidemics are managed in disease vertical programmes while various communicable and non-communicable diseases co-exist, and interact. To address the systemic bottlenecks in communicable and noncommunicable disease care in Tanzania; we propose an Adaptive Diseases control Expert Programme in Tanzania (acronym-ADEPT), focusing on the TB/DM co-epidemic. The project will study if and how integrated TB/DM diagnosis and novel technologies optimize management in client-friendly clinics including at primary health care (PHC) levels, may be developed and implemented, and if successful, inform policy and practice. The main outcomes include successful implementation of TB/DM management at all levels incl. PHC, as evidenced by increase of early detection of either disease, decrease of unfavourable treatment outcomes. Four Tanzanian institutes; Kibong’oto Infectious Diseases Hospital, Mbeya Medical Research Centre, Shree Hindu Mandal Hospital and Kilimanjaro Clinical Research Institute will implement the project. Section of Global Health, University of Copenhagen, Denmark will lead the programme and support capacity building in the applied research of dual TB/DM disease, in collaboration with the International Reference Laboratory of Mycobacteriology at Statens Serum Institut, supporting mycobacterial diagnostics, research, development, and quality assurance. Additional partners are University of Virginia, sub-contracted for support on therapeutic drug monitoring (TDM), and database design, and Groningen University, The Netherlands sub-contracted to provide technical expertise to adapt TDM to the field-friendly technique. Research capacity building includes 2 PhDs and 1Postdoc. The project budget is 10,000,000 DKK and will start on 2nd quarter of 2018 through 3rd quarter of 2023.
Outputs: We have registred two PhD students and one post-doc. We have created materials for TB-DM course for front-line health care providers It’s a two package course - one for the mentors (standardised care package) and one for the general health care workers (minimum package).