تعليقThe GDGs discussed research priorities and highlighted a number of priorities.
The effectiveness of different forms of interventions to improve treatment adherence
- The interventions for patient support and treatment supervision that are best suited to particular populations.
- The interventions for patient support that are most effective in low- and middle-income countries.
- Analysis of the cost-effectiveness of different types of incentives.
- Research into the effectiveness of VST in low- and middle-income countries, as the current available data are from high-income countries.
- The types of psychological support that are most appropriate
Models of care for all people with TB
- Evaluation of the risk of TB transmission in different settings – i.e. does treatment centered on hospital care or outpatient clinics pose a higher risk of transmission?
- Additional cost-effectiveness studies of decentralized versus centralized care.
- Many programmes are providing decentralized care, but very few have published the data. Programmes should be encouraged to publish – or at least systematically collect – their data.
Models of TB care for children and adolescents
Decentralization of TB services for children and adolescents with signs and symptoms of TB and for children and adolescents exposed to TB
- The cost-effectiveness of decentralization/integration for case detection and provision of TPT.
- The impact of decentralization of services on health equity.
- The acceptability and feasibility of decentralized approaches to child and adolescent TB care for case detection and for TPT provision
Family-centred, integrated services for children and adolescents with signs and symptoms of TB and for children and adolescents exposed to TB
- A detailed description of currently operating family-centred and integrated services, with associated costs and cost-effectiveness.
- Implementation research on the components of the interventions, and assessment of real-world implementation of the programmes.
- The acceptability and feasibility and of family-centred, integrated and/or decentralized approaches to child and adolescent TB care for case detection and TPT provision in different settings, from the perspectives of the persons with TB, the caregivers and providers.
- Costs and catastrophic costs.
- Cost-effectiveness evaluations of family-centred, integrated and/or decentralized approaches, considering currently available resources (N.B. some models assume that these interventions are built on existing structures that may not be available).
- Outcomes of interest: initiation of TPT; number of additional children and adolescents diagnosed; delay, retention in care, treatment completion, clinical outcomes (such as treatment success); qualitative research related to stigma, mental health outcome, school interruption, equity.
- Evaluation of outcomes of interest using randomized/non-randomized designs and qualitative designs.
- A baseline needs assessment in the community, community perceptions of TB care and prevention for children and adolescents.
- Research on the quality of TB diagnosis in children – addressing both under-diagnosis and over-diagnosis.