The Decide-TB project will evaluate this “comprehensive TDA approach” by responding to several specific questions:
Project Activities &
Questions
Decide-TB
Activities
Implement TDAs in routine care in district hospitals and primary health centres in Mozambique and Zambia, using innovative digital data collection and CDSS;
This will be done as a programmatic pilot, led by the national TB programs.
Do research and provide resulting scientific evidence on the effectiveness, the diagnostic performance, the cost and cost-effectiveness of TDAs; and identify adaptations required for specific sub-groups;
This will be done within a stepped wedge cluster-randomized trial, a meta-analysis of individual data from children with presumptive TB evaluated in recent prospective cohort studies, and economic evaluations.
Do research and provide results on the acceptability of and feasibility of TDAs by healthcare workers and implementation challenges which will be used to design tools for implementation of TDAs in contexts with different health system organisations, resources and local epidemiology;
This will be done within an interdisciplinary research programme combining qualitative and quantitative data from health care facilities, communities and decision-makers.
Build capacity and improve clinical practices of frontline HCWs for childhood TB through training, mentoring, and support supervision.
Collaborate with key stakeholders at local, national and international level, in order to ensure translation of scientific and operational evidence on TDAs into national policies and practices, scale-up plans at the national level, and international paediatric TB guidelines, and study mechanisms and determinants for policy adoption;
QUESTIONS TO BE ANSWERED BY DECIDE-TB
How acceptable is the “comprehensive TDA approach” to healthcare workers?
What are the main challenges involved in implementing TDAs at low levels of care?
Is this “comprehensive TDA approach” effective in improving the number of children who start treatment for tuberculosis?
What are the costs associated with the deployment of this “comprehensive TDA approach” at low levels of care?
To provide data on the implementation of TDAs for tuberculosis in children.
To develop and promote tools to make sure that this data is used in routine healthcare practice and in national public policies.