Telemedicine in Resource-Limited Settings to Optimize Care for Multidrug-Resistant Tuberculosis
The emergence and spread of multidrug-resistant tuberculosis (MDR-TB) poses a major threat to the global targets for TB control. In recent years, an evolving science and evidence base for MDR-TB has led to much needed changes in international guidelines promoting the use of newer TB drugs and regime...
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| Published in: | Frontiers in public health Vol. 7; p. 222 |
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| Main Authors: | , , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
Switzerland
Frontiers Media
13-08-2019
Frontiers Media S.A |
| Subjects: | |
| Online Access: | Get full text |
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| Summary: | The emergence and spread of multidrug-resistant tuberculosis (MDR-TB) poses a major threat to the global targets for TB control. In recent years, an evolving science and evidence base for MDR-TB has led to much needed changes in international guidelines promoting the use of newer TB drugs and regimens for MDR-TB, however, there remains a significant implementation gap. Due to the complexity of treating MDR-TB, management of cases is often supported by an expert multidisciplinary team, or clinical expert group. This service is often centralized, and may be delivered through a telemedicine platform. We have implemented a Web-based "store-and-forward" telemedicine service to optimize MDR-TB patient care in Daru, a remote and resource limited setting in Papua New Guinea (PNG). From April 2016 to February 2019, 237 cases were discussed using the service. This encompassed diagnostic (presumptive) and treatment cases, and more recently, support to the scale up of preventative therapy for latent TB infection. There were 75 cases in which the use of Bedaquiline was discussed or mentioned, with a high frequency of discussions occurring in the initial period (26 cases in the first 12 months), which has appeared to decrease as clinicians gained familiarity with use of the drug (15 cases in the last 12 months). This service has supported high quality clinical care and fostered collaboration between clinicians and technical experts in a shared learning environment. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Frontiers In Public Health Edited by: Harshad Thakur, Tata Institute of Social Sciences, India Reviewed by: Charles Doarn, University of Cincinnati, United States; Simon Tiberi, Queen Mary University of London, United Kingdom This article was submitted to Public Health Education and Promotion, a section of the journal Frontiers in Public Health |
| ISSN: | 2296-2565 2296-2565 |
| DOI: | 10.3389/fpubh.2019.00222 |