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miLINC: MDR-TB South Africa - Patient Linkage to and Retention in Care
Mycobacterium tuberculosis (TB) remains the leading cause of death among persons living with human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) in southern Africa. Drug-resistant TB remains a growing threat to public health despite advances made in diagnosis and treatment over the past decade. South Africa has the world’s highest rate of TB/HIV co-infection and ranks fourth worldwide for multi-drug resistant (MDR)-TB incidence and HIV prevalence.
In South Africa, the National Strategic Plan (NSP) for HIV, TB, and STIs 2012-2016 recommends treatment initiation of MDR-TB by professional nurses at the community level to increase timely access not only to second line drugs (SLD), but also to ongoing care and treatment. The development and effective evaluation of healthcare provider (HCP) training programs with strong clinical mentoring and advocacy are necessary to ensure access and improve patient outcomes in both MDR-TB and HIV. This program has grown from an initiative developed by Dr. Jason Farley. This program will be expanded to train 180 nurse practitioners and an additional 2500 healthcare workers across South Africa.
The Strategic Plan also recommends improving treatment initiation among MDR-TB patients from 56% to 75% of newly diagnosed persons. In addition, decreasing time to treatment initiation to less than 5 days is a priority. To accomplish this task, a mobile health (mhealth) approach is critical to this success. The emocha platform of mobile data management tools provides such a solution. emocha is a robust and versatile m-health platform capable of interfacing with multiple service providers to ensure seamless data collection, patient tracking and a host of other possibilities to meet the needs of South Africa. Once treatment has been initiated, emocha will continue to monitor and help coordinate the patient’s follow-up visits.