With 1.5 million deaths each year, tuberculosis (TB) is a threat to human health. My research program aims to enhance TB outcomes in resource-limited settings and among marginalized populations using patient-centred approaches to health services delivery.
Understanding the realities of South Africa's TB care cascade In South Africa, poor patient retention in TB health care services reflects gaps in the quality of care. Using mystery patients, we will assess the quality of TB care among 200 providers. We will measure the ‘know-do gap' between physician's knowledge of TB and actual practice, and identify challenges to the implementation of best practices for TB, TB-HIV and multi drug resistant (MDR) TB.
Engaging Community Pharmacists in India to Enhance Early Detection of Tuberculosis In India, patients commonly seek medical care from pharmacists. Using participatory methods and an mHealth platform, we have trained 105 community-based pharmacists to refer TB symptomatic adults for a radiograph followed by a doctor consultation. Preliminary evaluations suggest a reduction in TB diagnostic delay, and high patient and pharmacist acceptability.
Breaks in the cascade of care for immigrants with latent tuberculosis infection (LTBI) Most Canadian TB cases occur in the foreign-born. We propose to measure attrition in the LTBI care cascade among immigrants in Montreal. We will identify factors predicting retention, and assess barriers and facilitators to LTBI screening, treatment initiation and completion.
These projects are relevant for TB control globally and in Canada, with potential applications among indigenous populations.