Challenge TB (CTB) is the flagship global mechanisms for implementing USAID’s TB strategy, In Bangladesh, MSH is the leading organization and KNCV the Technical Support partner. The goal of CTB is To end the global TB epidemic, The project objectives and selected technical areas are aligned with the WHO End TB Strategy, the NTP’s National Strategic Plan, the latest JMM  and USAID/Bangladesh Country Development Cooperation Strategy. Challenge TB has three objectives, each with several focus areas for interventions:: 1) Improved access to high-quality patient centered TB,DR-TB & TB/HIV services.2) Prevention of  transmission and disease progression; and 3) strengthened TB service delivery platforms.

Bangladesh (approx. 160 million population) is both a high TB and a high MDR-TB burden country in  South Asia. The epidemic of TB in Bangladesh is generalized: prevalence is estimated at (402/100,000 population).1.4% of all new TB cases and 29% among retreatment cases are estimated to be drug resistant. Each year around 70,000 people die of TB. A prevalence survey is currently underway, with results expected in 2016. HIV prevalence is low in Bangladesh (less than 0.1%).

Challenge TB in Bangladesh is a 5 year USAID funded project supporting the National TB Program (NTP) in implementation of the national strategic plan for TB through ensuring technical assistance. The project helps the NTP in making strategic choices for a sustainable difference, ensuring the highest impact with limited resources.

 

mHealth by Challenge TB, Bangladesh:

Multi-drug-resistant tuberculosis (MDR-TB) is a multifaceted challenging issue for Bangladesh. Treatment for DR-TB requires a complex drug regimen which is delivered for about two years. Majority of patients are being provided this treatment, under the community based programmatic management of Drug resistant TB(cPMDT).The cPMDT program requires an initial 1-2 months of hospitalization for DR TB patients who are then transitioned to community based care, allowing patients to receive DR TB treatment in their own community.. At the community level, these patients continue their treatment under the supervision of specially trained DR TB DOT (directly observed treatment) providers. The Challenge TB(CTB) is continuing support for the mHealth application which is designed to support the DOT providers to ensure quality DOT, assist  to quickly identify drug related side effects and link patients to treatment, and above all assist in patient management by facilitating documentation of the management procedures.

 

The mHealth application is a web based monitoring tool which allows DOT providers and managers to keep track of services delivered and organize an electronic record of treatment history of the DR TB patients. This system is designed to receive information from mobile devices used by the DOT providers (Smart phone) through a GPS enabled mobile application. Aggregation of information is done at the server to analyze  drug or treatment  statistics, by time, geographic area, or DOT provider. There are 350 DOT providers now using the mHealth to send their MDR-TB patients history. This  mhealth application initiative reduces the turnaround time for reporting sub district, district, or national-level data, which is extremely useful for health managers  and policy makers.